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NPI Code Detail

MEDICARE: JACOB LARSEN

MEDICARE: JACOB LARSEN
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
1146L00000XParamedicCO

General Provider Information

NPI Number : 1760349047
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB LARSEN
Provider Business Mailing Address
First Line : 4856 INNOVATION DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-5539
Country : US
Telephone Number : 970-494-4200
Fax Number :
Provider Business Practice Location Address
First Line : 700 CENTRE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1842
Country : US
Telephone Number : 970-494-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2026
Last Update Date : 01/07/2026

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Directions to “ JACOB LARSEN ” Practice Location

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