CHARLES BLAISE LARSON (NPI# 1497120349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497120349 |
| Entity Type | Individual |
| Full Name | CHARLES BLAISE LARSON |
| Credential | FNP-BC |
| Practice Address |
730 N College Rd Ste B Twin Falls ID 83301-3382 |
| Mailing Address |
730 Nth College Rd # B Twin Falls ID 83301-3382 |
| Practice Telephone | 2088147350 |
| Mailing Telephone | 2087323066 |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2016-05-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP-1716A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437589181 | Charles Larson | Orthopaedic Surgery | 2431 Park Hill Dr, Longview, WA 98632-5785 | 2013-11-16 |
| 1184768129 | Charles E Larson | Family Medicine | Flci, W10237 Lake Emily Rd, Fox Lake, WI 54935-8525 | 2007-02-15 |
| 1588992291 | Charles Keith Larson | Pharmacist | 800 N Zaragoza Rd, El Paso, TX 79907-2519 | 2009-11-19 |
| 1326076217 | Charles P Larson Jr. | Anesthesiology | 300 Pasteur Dr, Stanford, CA 94305-2200 | 2006-06-29 |
| 1013973353 | Charles A Larson | Family Medicine | 2337 Homer Clayton Drive, Guntersville, AL 35976 | 2006-04-25 |
| 1518952209 | Charles C Larson | Internal Medicine | 5950 University Ave, Ste 221, West Des Moines, IA 50266-8216 | 2005-09-19 |
| Street Address |
730 N COLLEGE RD STE B |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-3382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629424171 | Robert Jensen | Audiologist | 730 N College Rd Ste B, Twin Falls, ID 83301-3382 | 2016-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659979516 | Jennifer Anne Gardner | Nurse Practitioner | 1385 Park View Dr Ste 101, Twin Falls, ID 83301-4390 | 2020-10-13 |
| 1518515949 | Carisa Dawn Elliott | Nurse Practitioner | 370 North Haven Drive, Twin Falls, ID 83301-6178 | 2019-08-28 |
| 1689163222 | Amanda Petersen | Nurse Practitioner | 775 Pole Line Rd W Ste 113, Twin Falls, ID 83301-5819 | 2018-05-09 |
| 1760990378 | Robin Lin Hall | Nurse Practitioner | 714 N College Rd Ste B, Twin Falls, ID 83301-5812 | 2018-01-17 |
| 1720513682 | Jennifer Marie Benally | Nurse Practitioner | 418 Madison St, Twin Falls, ID 83301-4721 | 2017-04-27 |
| 1366982621 | Stacie Mccomas | Nurse Practitioner | 476 Cheney Dr W, Suite 160, Twin Falls, ID 83301-3741 | 2017-03-06 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1063872489 | Blue Lakes Medicine Pa | Nurse Practitioner | 1122 Eastland Dr N, Ste 2, Twin Falls, ID 83301-8444 | 2016-02-26 |
| 1811354640 | Amra Suljevic | Nurse Practitioner | 775 Pole Line Rd W Ste 312, Twin Falls, ID 83301-5823 | 2016-01-25 |
| 1699144691 | Maricruz Davis | Nurse Practitioner | 850 Cambron Ave, Twin Falls, ID 83301-4789 | 2015-09-20 |
| Find all providers in TWIN FALLS | ||||
| City | TWIN FALLS |
| Zip Code | 83301 |
Please comment or provide details below to improve the information on CHARLES BLAISE LARSON.
| 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.