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General NPI Number Information
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NPI Number | 1659349934
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Entity Type | Individual
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Provider Name | JANET A LARSON PSYNP, PHD, FNP
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Gender | Female
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 200 BUNKER HILL DR
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City | AITKIN
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State | MN
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Zip | 56431-1865
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Country | US
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Telephone | 218-768-4011
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Fax | 218-768-4814
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Provider Business Mailing Address
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Address Line | 200 BUNKER HILL DR
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City | AITKIN
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State | MN
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Zip | 56431-1865
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Country | US
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Telephone | 218-927-2157
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Fax | 218-927-4130
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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 | R133861-6
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R133861-6
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License Number State | MN
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