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General NPI Number Information
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NPI Number | 1467372151
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Entity Type | Individual
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Provider Name | REBECCA LARSON
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Gender | Female
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 301 3RD AVE SE PO BOX 735
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City | CROSBY
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State | ND
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Zip | 58730-0735
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Country | US
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Telephone | 701-339-7580
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Fax |
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Provider Business Mailing Address
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Address Line | 301 3RD AVE SE PO BOX 735
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City | CROSBY
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State | ND
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Zip | 58730-0735
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Country | US
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Telephone | 701-339-7580
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 30244
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 30244
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 30244
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License Number State | ND
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