Provider Demographics
NPI:1972985489
Name:CHRISTINE TRUSCHKA LARSEN
Entity Type:Organization
Organization Name:CHRISTINE TRUSCHKA LARSEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:TRUSCHKA
Authorized Official - Last Name:LARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:352-572-8814
Mailing Address - Street 1:1835 SW 34TH CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-2836
Mailing Address - Country:US
Mailing Address - Phone:352-572-8814
Mailing Address - Fax:
Practice Address - Street 1:1835 SW 34TH CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-2836
Practice Address - Country:US
Practice Address - Phone:352-572-8814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL282N00000X, 282NR1301X, 302R00000X, 310400000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No282NR1301XHospitalsGeneral Acute Care HospitalRural
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility