Provider Demographics
NPI:1003115379
Name:KAPPAS-LARSON, PATRICIA ANN (DNP, APN-C)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:KAPPAS-LARSON
Suffix:
Gender:F
Credentials:DNP, APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2845 HAMLINE AVE N
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-7127
Mailing Address - Country:US
Mailing Address - Phone:651-631-6100
Mailing Address - Fax:651-631-6343
Practice Address - Street 1:2845 HAMLINE AVE N
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-7127
Practice Address - Country:US
Practice Address - Phone:651-631-6100
Practice Address - Fax:651-631-6343
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-62916-4363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNR-62916-4OtherSTATE BOARD OF NSG