Provider Demographics
NPI:1467864603
Name:LARSON, HEATHER (RN, CNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:LARSON
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 E 34TH ST
Mailing Address - Street 2:ESSENTIA HEALTH HIBBING CLINIC
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-5109
Mailing Address - Country:US
Mailing Address - Phone:218-263-1000
Mailing Address - Fax:
Practice Address - Street 1:730 E 34TH ST
Practice Address - Street 2:ESSENTIA HEALTH HIBBING CLINIC
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-5109
Practice Address - Country:US
Practice Address - Phone:218-263-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR170899-0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily