MRS. AMY LARSON (NPI# 1396152583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396152583 |
| Entity Type | Individual |
| Full Name | MRS. AMY LARSON |
| Credential | NP |
| Practice Address |
4151 Willowwood St Se Prior Lake MN 55372-4304 |
| Mailing Address |
17445 Grove Ave Lakeville MN 55044-9563 |
| Practice Telephone | 9522262600 |
| Mailing Telephone | 4062314357 |
| Enumeration Date | 2014-07-19 |
| Last Update Date | 2019-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5097 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
25508 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16490 W 78th St, Eden Prairie, MN 553464300 | 3042252500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841843091 | Amy Lynn Larson | Behavior Technician | 710 Buffalo St Ste 802, Corpus Christi, TX 78401-1902 | 2019-07-17 |
| 1679963284 | Amy Lynette Larson | Nurse Practitioner | 338 6th St # 101, Lewiston, ID 83501-2420 | 2015-02-03 |
| 1124360243 | Amy Reed Larson | Speech-Language Pathologist | 14428 Turning Leaf Dr., Orlando, FL 32828 | 2013-03-27 |
| 1043356819 | Amy Jeannette Larson | Emergency Medicine | 2930 Bush Mountain Ct Sw, Tumwater, WA 98512-6731 | 2007-01-29 |
| 1598311730 | Amy Larson | Lactation Consultant, Non-RN | 468 Main St, Oley, PA 19547-9256 | 2019-08-14 |
| 1639630478 | Amy Larson | Nurse Practitioner | 1414 Woodland Ave, Duluth, MN 55803-2624 | 2019-03-26 |
| 1558892935 | Amy Larson | Pharmacist | 2500 Ne Neff Rd, Bend, OR 97701-6015 | 2017-03-27 |
| 1740649037 | Amy Larson | Nurse Practitioner | 2500 82nd Pl, Urbandale, IA 50322-4329 | 2016-02-16 |
| 1477804664 | Amy Elizabeth Larson | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2012-09-27 |
| 1417285784 | Amy Elizabeth Larson | Physician Assistant | 130 Hospital Rd, Suite 101, Prince Frederick, MD 20678-4015 | 2009-11-25 |
| Street Address |
4151 WILLOWWOOD ST SE |
| City | PRIOR LAKE |
| State | MN |
| Zip Code | 55372-4304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053379230 | Karen Marie Weiler | Family Medicine | 4151 Willowwood St Se, Prior Lake, MN 55372-4304 | 2006-05-03 |
| 1639477854 | Fairview Pharmacy Services LLC | Pharmacy | 4151 Willowwood St Se, Prior Lake, MN 55372-4304 | 2011-03-11 |
| 1568654341 | Fairview Clinics | Clinic/Center | 4151 Willowwood St Se, Prior Lake, MN 55372-4304 | 2007-08-15 |
| 1144278755 | Jessica A Vanderscoff | Family Medicine | 4151 Willowwood St Se, Prior Lake, MN 55372-4304 | 2006-05-05 |
| 1073561619 | Troy A Scott | Family Medicine | 4151 Willowwood St Se, Prior Lake, MN 55372-4304 | 2006-05-05 |
| 1710945209 | Robert D Lehrer | Family Medicine | 4151 Willowwood St Se, Prior Lake, MN 55372-4304 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043830995 | Abby Lynn Quinnell | Physician Assistant | 19455 Towering Oaks Trl, Prior Lake, MN 55372 | 2020-04-21 |
| 1659914547 | Touching Lives Community, Inc. | Assisted Living Facility | 5554 Woodside Road, Se, Prior Lake, MN 55372 | 2019-10-23 |
| 1366961542 | Doreen Lubi Isubikalu | Family Medicine | 2330 Sioux Trail Nw, Prior Lake, MN 55372 | 2017-09-19 |
| 1760909519 | Terese Marie Sovis | Massage Therapist | 15140 Green Oaks Trail, Prior Lake, MN 55372 | 2017-08-23 |
| 1689805301 | Laura Grace Patton | Physician Assistant | 4151 Willowwood Street Se, Prior Lake, MN 55372 | 2009-07-29 |
| 1952582702 | Lilah Suzan Ekim Dds, Ms. Pllc | Dentist | 16190 Erie Ave Se, Prior Lake, MN 55372 | 2007-11-21 |
| 1679618326 | Basile Orthodontics Pa | Dentist | 5116 Gateway Street Se #103, Suite #103, Prior Lake, MN 55372 | 2007-02-20 |
| 1700890134 | Shakopee Mdewakanton Emergency Services | Ambulance | 2525 Flandreau Trail, Prior Lake, MN 55372 | 2006-07-28 |
| 1548299167 | Darlene Merchant | Psychologist | 15815 Franklin Trail S.e., Suite 308 Darlene Merchant, M.a., L.p., Prior Lake, MN 55372 | 2006-07-03 |
| 1508806530 | Kelly Brooks | Nurse Anesthetist, Certified Registered | 3564 Willow Beach St Sw, Prior Lake, MN 55372 | 2006-06-07 |
| Find all providers in zip 55372 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245504117 | Consult Care LLC | Nurse Practitioner | 18521 Pheasant Ridge Rd, Prior Lake, MN 55372-9705 | 2012-02-23 |
| 1356300297 | Helen Jane Peterson | Nurse Practitioner | 2300 Sioux Trl Nw, Prior Lake, MN 55372-9077 | 2006-03-20 |
| 1710906581 | Melanie J Dunlap | Nurse Practitioner | 4670 Park Nicollet Ave Se, Prior Lake, MN 55372-4119 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466368 | Amalia Jo Folland Harvey | Nurse Practitioner | 19883 Evensong Ct, Farmington, MN 55024-8688 | 2020-10-29 |
| 1710586235 | Jackelyn Laura Peterson | Nurse Practitioner | 10101 Bren Rd E Unit 345, Minnetonka, MN 55343-0060 | 2020-10-26 |
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1861091704 | Morgan Rohl | Nurse Practitioner | 117 12th Ave Nw Apt 2, Rochester, MN 55901-2787 | 2020-10-21 |
| 1063010304 | Kalie R Mccauley | Nurse Practitioner | 11452 Brook Rd Nw, Elk River, MN 55330-8739 | 2020-10-09 |
| 1659978930 | Sarah Jean Mudge | Nurse Practitioner | 350 Harbor Dr, Duluth, MN 55802-2600 | 2020-10-08 |
| 1285231621 | Karlu Dorleh | Nurse Practitioner | 14151 Territorial Rd Unit 212, Maple Grove, MN 55369-5725 | 2020-10-08 |
| 1447857669 | Kimberly Dawn Bursch-tewalt | Nurse Practitioner | 11884 237th Ave Nw, Elk River, MN 55330-8255 | 2020-10-01 |
| 1639786312 | Peter Wahl | Nurse Practitioner | 4652 Lyndale Ave S, Minneapolis, MN 55419-5302 | 2020-09-28 |
| 1568078616 | Joanna Kay Rehm | Nurse Practitioner | 3025 Eagandale Pl Apt 338, Eagan, MN 55121-1236 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
| City | PRIOR LAKE |
| Zip Code | 55372 |
Please comment or provide details below to improve the information on MRS. AMY LARSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.