Shelly L Larson (NPI# 1982690145, PAC ID# 9436052057) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
Nation Provider ID (NPI) | 1982690145 |
PAC ID by PECOS | 9436052057 |
Professional Enrollment ID | I20040130000573 |
Full Name | Shelly L Larson |
Organization Legal Name | ADVANCED DERMATOLOGY CARE MEDICAL COSMETIC AND SURGERY PA |
Address |
25 Lake St N Suite 200 Forest Lake MN 55025-2537 |
Phone Number | 6514302724 |
Gender | F |
Credential | PA |
Graduation Year | 2003 |
Primary Specialty | PHYSICIAN ASSISTANT |
Group Practice PAC ID | 4385633767 |
Number of Group Practice Members | 6 |
Accepts Medicare Assignment | Y |
Address | Phone | Organization |
---|---|---|
25 Lake St N, Suite 200, Forest Lake, MN 55025-2537 | 6514302724 | ADVANCED DERMATOLOGY CARE MEDICAL COSMETIC AND SURGERY PA |
4480 Centerville Rd, Saint Paul, MN 55127-3674 | 6514842724 | ADVANCED DERMATOLOGY CARE MEDICAL COSMETIC AND SURGERY PA |
14130 60th St N, Stillwater, MN 55082-6354 | 6514842724 | ADVANCED DERMATOLOGY CARE MEDICAL COSMETIC AND SURGERY PA |
Organization Legal Name | ADVANCED DERMATOLOGY CARE MEDICAL COSMETIC AND SURGERY PA |
Physicians | 5 |
Name | Specialty | Organization | Address |
---|---|---|---|
Heather M Kill | Physician Assistant | Advanced Dermatology Care Medical Cosmetic and Surgery Pa | 14130 60th St N, Stillwater, MN 55082-6354 |
Olaf J Rustad | Dermatology | Advanced Dermatology Care Medical Cosmetic and Surgery Pa | 25 Lake St N, Suite 200, Forest Lake, MN 55025-2537 |
Emily K Burkman | Physician Assistant | Advanced Dermatology Care Medical Cosmetic and Surgery Pa | 25 Lake St N, Suite 200, Forest Lake, MN 55025-2537 |
Ruth A Rustad | Internal Medicine | Advanced Dermatology Care Medical Cosmetic and Surgery Pa | 25 Lake St N, Suite 200, Forest Lake, MN 55025-2537 |
Street Address |
25 LAKE ST N SUITE 200 |
City | FOREST LAKE |
State | MN |
Zip | 55025-2537 |
Name | Specialty | Organization | Address |
---|---|---|---|
Olaf J Rustad | Dermatology | Advanced Dermatology Care Medical Cosmetic and Surgery Pa | 25 Lake St N, Suite 200, Forest Lake, MN 55025-2537 |
Emily K Burkman | Physician Assistant | Advanced Dermatology Care Medical Cosmetic and Surgery Pa | 25 Lake St N, Suite 200, Forest Lake, MN 55025-2537 |
Ruth A Rustad | Internal Medicine | Advanced Dermatology Care Medical Cosmetic and Surgery Pa | 25 Lake St N, Suite 200, Forest Lake, MN 55025-2537 |
Name | Specialty | Organization | Address |
---|---|---|---|
Steven Z Johnson | Chiropractic | 31 7th Sw Ave, Forest Lake, MN 55025 | |
Beth R Reitzel | Clinical Social Worker | Canvas Health Inc | 555 W Broadway Ave 2 And, Suite 3, Forest Lake, MN 55025-1066 |
Barry J Larson | Geriatric Medicine | Geriatric Services of Minnesota LLC | 604 1st Nest, Forest Lake, MN 55025-1207 |
Kyle Lewis | Chiropractic | Forest Lake Chiropractic Clinic, P.a. | 591 N Shore Dr, Forest Lake, MN 55025-1217 |
David J Lewis | Chiropractic | Forest Lake Chiropractic Clinic, P.a. | 591 N Shore Dr, Forest Lake, MN 55025-1217 |
Richard D Bruesch | Optometry | 200 12th St Sw, Wal Mart Vision Center, Forest Lake, MN 55025-1482 | |
Scott Richard Telander | Optometry | Forest Lake Optometric Center | 20 Lake St N, Suite 101, Forest Lake, MN 55025-2510 |
Kevin L Bahr | Optometry | Forest Lake Optometric Center | 20 Lake St N, Suite 101, Forest Lake, MN 55025-2510 |
Daniel William Solbrack | Optometry | Forest Lake Optometric Center | 20 Lake St N, Suite 101, Forest Lake, MN 55025-2510 |
Derek J Scheevel | Physical Therapy | Therapy Partners Inc | 146 Lake St N, Forest Lake, MN 55025-2518 |
Find all physicians in zip 55025 |
City | FOREST LAKE |
Zip Code | 55025 |
Specialty | PHYSICIAN ASSISTANT |
City + Specialty | FOREST LAKE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Shelly L Larson.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.