Larson, Lisa

Larson, Lisa is an individual health care provider with primary practice located at 500 S Maple St , Waconia MN 55387-1752. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Larson, Lisa can be contacted via phone (952) 442-2191.

Contact Information

Primary practice address
500 S Maple St Waconia MN 55387-1752
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 34233 Minnesota

Profile Details

NPI number 1558300111
LBN Legal business name Larson, Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Dec 4th, 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 1558300111 NPPES
Other 112880 UARE
Other HP13847 UARE
Other 1041153 UARE
Other 39-22833 UARE
Other 3F850LO UARE

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