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NPI Code Detail

MEDICARE: MRS. KARI K LARSON PA-C

MEDICARE: MRS. KARI K LARSON PA-C
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
1363A00000XPhysician Assistant9395MN

General Provider Information

NPI Number : 1972588879
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KARI K LARSON PA-C
Provider Business Mailing Address
First Line : 4200 DAHLBERG DR STE 300
Second Line :
City : GOLDEN VALLEY
State : MN
Zip : 55422-4841
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4010 W 65TH ST
Second Line :
City : EDINA
State : MN
Zip : 55435-1706
Country : US
Telephone Number : 952-456-7000
Fax Number : 952-456-7001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 08/03/2022

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Directions to “ MRS. KARI K LARSON PA-C” Practice Location

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