Healthcare Provider Details

I. General information

NPI: 1225317761
Provider Name (Legal Business Name): CHRISTENSIA NENG LARKEY MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1015
FOREST LAKE MN
55025-5015
US

IV. Provider business mailing address

PO BOX 1015
FOREST LAKE MN
55025-5015
US

V. Phone/Fax

Practice location:
  • Phone: 651-705-8723
  • Fax: 651-212-4003
Mailing address:
  • Phone: 651-705-8723
  • Fax: 651-212-4003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberN/A
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: