Provider Demographics
NPI:1043231376
Name:LARSEN, MEGAN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:LARSEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2493
Mailing Address - Country:US
Mailing Address - Phone:828-274-7502
Mailing Address - Fax:828-271-6599
Practice Address - Street 1:20 MEDICAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2493
Practice Address - Country:US
Practice Address - Phone:828-274-7502
Practice Address - Fax:828-271-6599
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELH0000161363L00000X
NC5010208363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000032820Medicaid
DE014089S17Medicare PIN
DE1000032820Medicaid