ANGELA MARIE LARSON (NPI# 1477683365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477683365 |
| Entity Type | Individual |
| Full Name | ANGELA MARIE LARSON |
| Practice Address |
1920 Grant St Nw Faribault MN 55021-4831 |
| Mailing Address |
1822 Prairie Ave Sw Faribault MN 55021-5517 |
| Practice Telephone | 5073341555 |
| Practice Fax Number | 5073349030 |
| Mailing Telephone | 5073326714 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2009-03-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 117414 | MN | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 106928000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003315763 | Angela Lynn Larson | Dietitian, Registered | 3806 S Medford Dr, Lufkin, TX 75901-5780 | 2018-02-08 |
| 1073783205 | Angela Marie Larson | Chiropractor | 1811 Bull St, Columbia, SC 29201-2505 | 2008-03-04 |
| 1275618399 | Angela L Larson | Nurse Practitioner | 111 Hundertmark Rd Ste 440, Chaska, MN 55318-1460 | 2006-10-26 |
| 1063010130 | Angela G Larson | Counselor | 1211 Merriam St, Davenport, WA 99122-8654 | 2020-10-12 |
| 1093026387 | Angela Noel Larson | Family Medicine | 907 Georgiana St, Port Angeles, WA 98362 | 2010-07-01 |
| 1740277896 | Angela L Larson | Physician Assistant | 200 1st St Sw, Rochester, MN 55905-0001 | 2005-10-04 |
| 1164418646 | Angela Renae Larson | Counselor | 123 19th St Ne, Watertown, SD 57201-2823 | 2005-09-21 |
| Street Address |
1920 GRANT ST NW |
| City | FARIBAULT |
| State | MN |
| Zip Code | 55021-4831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467450932 | Deborah Ann Thibodeau | Pharmacist | 1920 Grant St Nw, Faribault, MN 55021-4831 | 2005-07-08 |
| 1629584644 | Scott Casper | Pharmacist | 1920 Grant St Nw, Faribault, MN 55021-4831 | 2017-12-28 |
| 1336545318 | Stacy Vevea | Dietitian, Registered | 1920 Grant St Nw, Faribault, MN 55021-4831 | 2014-11-18 |
| 1174943716 | Kelsey Ahlers | Dietitian, Registered | 1920 Grant St Nw, Faribault, MN 55021-4831 | 2014-04-22 |
| 1982044905 | Ayn Tanya Pavek | Dietitian, Registered | 1920 Grant St Nw, Faribault, MN 55021-4831 | 2013-07-05 |
| 1619270477 | Jessica A Grassmann | Pharmacist | 1920 Grant St Nw, Faribault, MN 55021-4831 | 2010-12-15 |
| 1053340711 | Hy Vee Inc | Durable Medical Equipment & Medical Supplies | 1920 Grant St Nw, Faribault, MN 55021-4831 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872831 | Kent William Lundstrom | Pharmacist | 612 4th Street Nw, Faribault, MN 55021 | 2020-08-19 |
| 1053957357 | M&t Sisters of Serendipity Pllc | Counselor | 212a Centralave, Faribault, MN 55021 | 2019-11-21 |
| 1639720485 | Reliable Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 200 8th Avenue Nw, Faribault, MN 55021 | 2019-09-24 |
| 1235663428 | Tanya Borchert | Social Worker | 100 State Avenue, Faribault, MN 55021 | 2017-04-14 |
| 1235589854 | Bashir Omar I | Interpreter | 2426 Park Ave # 309, Faribault, MN 55021 | 2016-06-14 |
| 1790150381 | Rainbow United Care Transportation LLC | Non-emergency Medical Transport (VAN) | 1738 Patrick Bay, Faribault, MN 55021 | 2015-12-08 |
| 1740625938 | Steven James Klapmeier | Family Medicine | 1101 Linden Lane, Mcfffrb Health Service, Faribault, MN 55021 | 2013-05-02 |
| 1528306040 | Discovery Public School of Faribault | Local Education Agency (LEA) | 126 8th St. Nw, Faribault, MN 55021 | 2013-01-17 |
| 1164790374 | Emmanuel Douah | Pharmacist | 612 4th Avenue Nw, Faribault, MN 55021 | 2011-12-02 |
| 1770873937 | Faribault Senior Living LLC | Assisted Living Facility | 843 Faribault Road, Faribault, MN 55021 | 2011-04-08 |
| Find all providers in zip 55021 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872831 | Kent William Lundstrom | Pharmacist | 612 4th Street Nw, Faribault, MN 55021 | 2020-08-19 |
| 1164790374 | Emmanuel Douah | Pharmacist | 612 4th Avenue Nw, Faribault, MN 55021 | 2011-12-02 |
| 1588655393 | William Howard Boyes | Pharmacist | 301 Central Ave N, Faribault, MN 55021-5214 | 2005-10-31 |
| 1467450932 | Deborah Ann Thibodeau | Pharmacist | 1920 Grant St Nw, Faribault, MN 55021-4831 | 2005-07-08 |
| 1952901720 | Rahwa Tesfe | Pharmacist | 150 Western Ave Nw, Faribault, MN 55021-4504 | 2020-10-29 |
| 1396343356 | Bradley Peters | Pharmacist | 150 Western Ave Nw, Faribault, MN 55021-4504 | 2020-10-13 |
| 1699386466 | Ngoc Vuong | Pharmacist | 612 4th St Nw, Faribault, MN 55021-5035 | 2020-08-13 |
| 1629584644 | Scott Casper | Pharmacist | 1920 Grant St Nw, Faribault, MN 55021-4831 | 2017-12-28 |
| 1063774834 | Heather Cay Bolstad | Pharmacist | 150 Western Ave Nw, Faribault, MN 55021-4504 | 2012-06-07 |
| 1235410655 | Benjamin James Cooper | Pharmacist | 612 4th St Nw, Faribault, MN 55021-5035 | 2011-08-30 |
| Find all providers in FARIBAULT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.