AMY ELIZABETH LARSON


Address: 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528
Phone: 4142987280

AMY ELIZABETH LARSON (NPI# 1477804664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477804664
Entity Type Individual
Full Name AMY ELIZABETH LARSON
Credential PA-C
Practice Address 2350 N Lake Dr
Suite 206
Milwaukee
WI 53211-4528
Mailing Address 8070 Horseshoe Bend Rd
Blanchardville
WI 53516-9147
Practice Telephone 4142987280
Enumeration Date 2012-09-27
Last Update Date 2012-09-27
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
Physician Assistants & Advanced Practice Nursing Providers

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1043356819 Amy Jeannette Larson Emergency Medicine 2930 Bush Mountain Ct Sw, Tumwater, WA 98512-6731 2007-01-29
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1558892935 Amy Larson Pharmacist 2500 Ne Neff Rd, Bend, OR 97701-6015 2017-03-27
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Office Location

Street Address 2350 N LAKE DR
SUITE 206
City MILWAUKEE
State WI
Zip Code 53211-4528

Providers in the same location

NPI Name Taxonomy Address Enumeration
1194721407 Nguyen H Phan Internal Medicine 2350 N Lake Dr, Ste 206, Milwaukee, WI 53211-4528 2005-06-22
1326650698 Dylan Henry Menefee Physician Assistant 2350 N Lake Dr, Milwaukee, WI 53211-4528 2020-08-18
1659936169 Cadie Leigh Roszak Nurse Practitioner 2350 N Lake Dr, Milwaukee, WI 53211-4528 2019-05-09
1457884165 Shelly A. Boyd Nurse Practitioner 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 2017-04-10
1043663818 Kelly Brock Physician Assistant 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 2016-07-18
1376996397 Jennifer Gallagher Physician Assistant 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 2016-07-14
1104285873 Catherine Bares Nurse Practitioner 2350 N Lake Dr, Suite 100, Milwaukee, WI 53211-4528 2016-02-23
1578921375 Heather Bastjan Nurse Practitioner 2350 N Lake Dr, Suite 500, Milwaukee, WI 53211-4528 2016-02-08
1033586292 Angela Kraus Nurse Practitioner 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 2015-08-24
1871974964 Tatyana Trendafilova Radulovic Nurse Practitioner 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 2015-06-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1821602335 Gabriella Caitrin Emanuele Occupational Therapist Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 2020-09-02
1710527783 Sage Specialty Pharmacy Inc. Pharmacy 4001 N. Oakland Ave, Shorewood, WI 53211 2020-01-08
1861043952 Rosina Bloomingdale Norton Nurse Practitioner 1921 E Harford Ave, Milwaukee, WI 53211 2019-09-20
1528556255 Renee Reckelberg Specialist/Technologist 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 2018-04-27
1700325602 Wisconsin Vision, Inc. Optometrist 4163 N Oakland Ave, Shorewood, WI 53211 2017-02-13
1750827556 Daniel Butz M.d., S.c. Plastic Surgery 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 2017-01-17
1528517232 Therese Simonis Speech-Language Pathologist 2390 N Lake Drive, Milwaukee, WI 53211 2016-09-23
1982075701 Katie Michel Specialist/Technologist 3409 N. Downer Ave, Milwaukee, WI 53211 2015-10-20
1255776365 Sarah Elizabeth Brill Social Worker 4433 N Oakland Ave Ste D, Shorewood, WI 53211 2013-05-02
1679814537 Nicole Anne Parulski Physical Therapist 2301 North Lake Dr, Milwaukee, WI 53211 2013-03-01
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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1194956417 Jessica Dawn Hagen Physician Assistant 5330 W. Villard Avenue, Milwaukee, WI 53218 2009-08-04
1245335868 Mary Laan Physician Assistant 8901 N. 76th Street, Milwaukee, WI 53223 2006-09-14
1326081316 Therese Ann Johnson Physician Assistant 3267 S 16th Street, Ems Office, Milwaukee, WI 53215 2006-06-14
1386686905 Irum Ziauddin Physician Assistant 3201 S 16th St Ste 2015, Milwaukee, WI 53215-4532 2006-06-11
1528054897 Nicole Meyer Papermaster Physician Assistant 342 N Water St Ste 600, Milwaukee, WI 53202-5715 2005-09-22
1285232793 Trina Kessel Physician Assistant 5000 W National Ave, Milwaukee, WI 53295-0001 2020-10-16
1124641113 Emily Rose Johnson Physician Assistant 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 2020-05-25
1487273561 Savannah Mathe Physician Assistant 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 2020-04-09
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Competitor

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City MILWAUKEE
Zip Code 53211

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Dataset Information

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.

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