Larson, Leah M

Larson, Leah M is an individual health care provider with primary practice located at 15855 19 Mile Rd , Clinton Twp MI 48038-3504. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Larson, Leah M can be contacted via phone (586) 263-2371.

Contact Information

Primary practice address
15855 19 Mile Rd Clinton Twp MI 48038-3504
Phone: (586) 263-2371
Fax: (586) 263-2596
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704186606 Michigan

Profile Details

NPI number 1205997616
LBN Legal business name Larson, Leah M
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
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 1205997616 NPPES
Michigan MEDICAID 4719920

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