MEDICARE: LAUREN PATRICIA LARSEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	0000222615	TN
2	163W00000X	Registered Nurse	9638789	FL
3	367500000X	Certified Registered Nurse Anesthetist	RN9638789	FL
4	367500000X	Certified Registered Nurse Anesthetist	11027971	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467137687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN PATRICIA LARSEN

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:	717-851-6969

Provider Business Practice Location Address
First Line	:	5151 N 9TH AVE
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32504-8721
Country	:	US
Telephone Number	:	850-416-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2023
Last Update Date	:	03/04/2026

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Directions to “ LAUREN PATRICIA LARSEN ” Practice Location

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