Larson, Jean E

Larson, Jean E is an individual health care provider with primary practice located at 2405 Osler Ct Meredyth Professional Plaza, Albany GA 31707. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Larson, Jean E can be contacted via phone (229) 435-1458.

Contact Information

Primary practice address
2405 Osler Ct Meredyth Professional Plaza Albany GA 31707
Fax: (229) 317-2342
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X GA4044 Georgia

Profile Details

NPI number 1295836732
LBN Legal business name Larson, Jean E
Credentials PA C
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Nov 4th, 2010 - about 14 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 1295836732 NPPES
Georgia MEDICAID 671629810B

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