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General NPI Number Information
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NPI Number | 1124016563
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Entity Type | Individual
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Provider Name | CHRISTINE AAS-LARSON RN, CNP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 12/03/2019
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Provider Practice Location Address
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Address Line | 1502 LONDON ROAD SUITE 102
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City | DULUTH
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State | MN
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Zip | 55812
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Country | US
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Telephone | 218-576-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 400 EAST 3RD STREET MSS 6AV-1
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City | DULUTH
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State | MN
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Zip | 55805-1951
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Country | US
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Telephone | 218-786-8364
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R142441-0
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License Number State | MN
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