MEDICARE: JENNIFER LARSON FNP

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
1	363LF0000X	Family Nurse Practitioner	0024180022	VA

General Provider Information

NPI Number	:	1912512856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LARSON FNP

Provider Business Mailing Address
First Line	:	213 S JEFFERSON ST STE 1006
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24011-1713
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1454 ROANOKE RD
Second Line	:
City	:	DALEVILLE
State	:	VA
Zip	:	24083-2935
Country	:	US
Telephone Number	:	540-992-3600
Fax Number	:	540-992-5570

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2020
Last Update Date	:	12/22/2025

Similar Medicare Providers

1457356982 — MR. GREGORY D HORNBACK LPC
Practice Location Address:

1450 ROANOKE RD
DALEVILLE, VA
24083-2935

Practice Phone: 540-526-4673
Practice Fax: 540-591-9914

1114241312 — ELIZABETH ANNE KEETER DC
Practice Location Address:

1450 ROANOKE RD
DALEVILLE, VA
24083-2935

Practice Phone: 540-966-0920
Practice Fax: 844-777-1745

1982928081 — ELIZABETH KEETER D.C. LLC
Practice Location Address:

1450 ROANOKE RD
DALEVILLE, VA
24083-2935

Practice Phone: 907-841-1495
Practice Fax:

1699021493 — MRS. SHERRY MICHELLE BOONE ACNPC
Practice Location Address:

1454 ROANOKE RD
DALEVILLE, VA
24083-2935

Practice Phone: 540-312-3981
Practice Fax:

1871048991 — DR. JUSTIN J PASSERINI D.C, M.S., R.D
Practice Location Address:

1400 ROANOKE RD
DALEVILLE, VA
24083-2935

Practice Phone: 540-992-6637
Practice Fax:

1164253183 — OPTIMAL FUNCTION AND WELLNESS, PLLC
Practice Location Address:

1454 ROANOKE RD
DALEVILLE, VA
24083-2935

Practice Phone: 540-312-3981
Practice Fax:

Directions to “ JENNIFER LARSON FNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.