| Jeannie Therese Larson, MD | |
|
9555 Upland Lane N, Maple Grove, MN 55369 | |
| (952) 993-3260 | |
| Not Available |
| Full Name | Jeannie Therese Larson |
|---|---|
| Gender | Female |
| Speciality | Dermatology |
| Experience | 40 Years |
| Location | 9555 Upland Lane N, Maple Grove, Minnesota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164406369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 33568 (Minnesota) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 33568 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Park Nicollet Methodist Hospital | Saint louis park, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Park Nicollet Clinic | 7911819438 | 1611 |
| Entity Name | Park Nicollet Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeannie Therese Larson, MD 8170 33rd Ave S, P.o. Box 1309 Mail Stop 21110q, Minneapolis, MN 55425-4516 Ph: (952) 993-3260 | Jeannie Therese Larson, MD 9555 Upland Lane N, Maple Grove, MN 55369 Ph: (952) 993-3260 |
Ronda Farah, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 14500 99th Ave N, Maple Grove, MN 55369 Phone: 763-898-1570 Fax: 763-898-1576 | |
Dr. Kathleen Maccarthy Demanivel, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 14500 99th Ave N, Maple Grove, MN 55369 Phone: 763-898-1000 | |
Dr. Sheilagh M Maguiness, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 14500 99th Ave N, Maple Grove, MN 55369 Phone: 763-898-1000 | |
Amrita Goyal-o'leary, Dermatology Medicare: Accepting Medicare Assignments Practice Location: 9555 Upland Ln N, Maple Grove, MN 55369 Phone: 952-993-3376 | |
Heidi G H Cole, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 9555 Upland Lane North, Maple Grove, MN 55369 Phone: 952-993-1440 | |
Dr. Jill Katherine Wieser, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 7840 Vinewood Ln N, Maple Grove, MN 55369 Phone: 763-236-0200 |