Larson, Diane Jean

Larson, Diane Jean is an individual health care provider with primary practice located at W2273 Koene Ct , Sheboygan Falls WI 53085-2719. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Larson, Diane Jean can be contacted via phone (920) 467-6803.

Contact Information

Primary practice address
W2273 Koene Ct Sheboygan Falls WI 53085-2719
Phone: (920) 467-6803
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 20152031 Wisconsin

Profile Details

NPI number 1447462635
LBN Legal business name Larson, Diane Jean
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447462635 NPPES
Wisconsin MEDICAID 35028400

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