Larson, Jeffrey R

Larson, Jeffrey R is an individual health care provider with primary practice located at 201 State St , Erie PA 16550-0002. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Larson, Jeffrey R can be contacted via phone (814) 877-6139.

Contact Information

Primary practice address
201 State St Erie PA 16550-0002
Phone: (814) 877-6139
Fax: (814) 877-6093
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X SP007048 Pennsylvania

Profile Details

NPI number 1679553937
LBN Legal business name Larson, Jeffrey R
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated May 23rd, 2012 - about 12 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 1679553937 NPPES
New York Other 02799186 NY MEDICAL ASSISTANC
New York Other 3000584 NY MEDICAL ASSISTANC

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