Jennifer Larson

Individual provider Active NPI Licensed Practical Nurse · Hutchinson, MN

NPI 1972178952 · NPPES record last updated May 23, 2021

Key facts

NPI
1972178952
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
819089 (MN)
Practice address
1460 Montreal St SE
Hutchinson, MN 55350-3318
Phone
(320) 587-2509
NPI assigned
May 23, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
819089MNMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Drug Stores Inc Past
since Jun 22, 2021
Accepting new patients
Thrifty Drug Stores Inc Past
since Jun 22, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 819089 MN Yes

Addresses

Primary practice location

1460 Montreal St SE
Hutchinson, MN 55350-3318

Mailing address

745 Century Ave SW Apt 203
Hutchinson, MN 55350-3736
Phone (320) 405-6467

Other providers in Hutchinson, MN

All providers in Hutchinson, MN · Licensed Practical Nurse in Minnesota

Sources for this page

Verify at the official NPI Registry.