AMY ELIZABETH LARSON (NPI# 1477804664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1477804664 |
Entity Type | Individual |
Full Name | AMY ELIZABETH LARSON |
Credential | PA-C |
Practice Address |
2350 N Lake Dr Suite 206 Milwaukee WI 53211-4528 |
Mailing Address |
8070 Horseshoe Bend Rd Blanchardville WI 53516-9147 |
Practice Telephone | 4142987280 |
Enumeration Date | 2012-09-27 |
Last Update Date | 2012-09-27 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
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 |
1396152583 | Amy Larson | Nurse Practitioner | 4151 Willowwood St Se, Prior Lake, MN 55372-4304 | 2014-07-19 |
1417285784 | Amy Elizabeth Larson | Physician Assistant | 130 Hospital Rd, Suite 101, Prince Frederick, MD 20678-4015 | 2009-11-25 |
Street Address |
2350 N LAKE DR SUITE 206 |
City | MILWAUKEE |
State | WI |
Zip Code | 53211-4528 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194721407 | Nguyen H Phan | Internal Medicine | 2350 N Lake Dr, Ste 206, Milwaukee, WI 53211-4528 | 2005-06-22 |
1326650698 | Dylan Henry Menefee | Physician Assistant | 2350 N Lake Dr, Milwaukee, WI 53211-4528 | 2020-08-18 |
1659936169 | Cadie Leigh Roszak | Nurse Practitioner | 2350 N Lake Dr, Milwaukee, WI 53211-4528 | 2019-05-09 |
1457884165 | Shelly A. Boyd | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2017-04-10 |
1043663818 | Kelly Brock | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-18 |
1376996397 | Jennifer Gallagher | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-14 |
1104285873 | Catherine Bares | Nurse Practitioner | 2350 N Lake Dr, Suite 100, Milwaukee, WI 53211-4528 | 2016-02-23 |
1578921375 | Heather Bastjan | Nurse Practitioner | 2350 N Lake Dr, Suite 500, Milwaukee, WI 53211-4528 | 2016-02-08 |
1033586292 | Angela Kraus | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2015-08-24 |
1871974964 | Tatyana Trendafilova Radulovic | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2015-06-15 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
Find all providers in zip 53211 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093348542 | Christopher Sean Lanctin | Physician Assistant | 557 N 17th St Apt 310, Milwaukee, WI 53233-2128 | 2020-02-12 |
1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
1194956417 | Jessica Dawn Hagen | Physician Assistant | 5330 W. Villard Avenue, Milwaukee, WI 53218 | 2009-08-04 |
1245335868 | Mary Laan | Physician Assistant | 8901 N. 76th Street, Milwaukee, WI 53223 | 2006-09-14 |
1326081316 | Therese Ann Johnson | Physician Assistant | 3267 S 16th Street, Ems Office, Milwaukee, WI 53215 | 2006-06-14 |
1386686905 | Irum Ziauddin | Physician Assistant | 3201 S 16th St Ste 2015, Milwaukee, WI 53215-4532 | 2006-06-11 |
1528054897 | Nicole Meyer Papermaster | Physician Assistant | 342 N Water St Ste 600, Milwaukee, WI 53202-5715 | 2005-09-22 |
1285232793 | Trina Kessel | Physician Assistant | 5000 W National Ave, Milwaukee, WI 53295-0001 | 2020-10-16 |
1124641113 | Emily Rose Johnson | Physician Assistant | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2020-05-25 |
1487273561 | Savannah Mathe | Physician Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-04-09 |
Find all providers in MILWAUKEE |
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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.