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NPI Code Detail

MEDICARE: CLAIRE O'NEILL LARSON PA-C

MEDICARE:   CLAIRE O'NEILL LARSON  PA-C
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
1363A00000XPhysician Assistant12961MN

General Provider Information

NPI Number : 1609334200
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAIRE O'NEILL LARSON PA-C
Provider Business Mailing Address
First Line : 13205 ISLE DR
Second Line :
City : BAXTER
State : MN
Zip : 56425-8554
Country : US
Telephone Number : 218-454-7600
Fax Number : 218-454-7681
Provider Business Practice Location Address
First Line : 13205 ISLE DR
Second Line :
City : BAXTER
State : MN
Zip : 56425-8554
Country : US
Telephone Number : 218-454-7600
Fax Number : 218-454-7681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2019
Last Update Date : 10/28/2024

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Directions to “ CLAIRE O'NEILL LARSON PA-C” Practice Location

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