Provider Demographics
NPI:1326077645
Name:LARSON, MARGARET JEAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:JEAN
Last Name:LARSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:117 N SKYTOP RD
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-2410
Mailing Address - Country:US
Mailing Address - Phone:814-734-3088
Mailing Address - Fax:814-337-4222
Practice Address - Street 1:18955 PARK AVENUE PLZ
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-4015
Practice Address - Country:US
Practice Address - Phone:814-337-0170
Practice Address - Fax:814-337-4222
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA139N1402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily