| Thad Peter Larson, CRNA | |
|
612 S Sibley Ave, Litchfield, MN 55355-3340 | |
| (320) 693-3242 | |
| Not Available |
| Full Name | Thad Peter Larson |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 612 S Sibley Ave, Litchfield, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477844439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R200065-5 (Minnesota) | Primary |
| Entity Name | County Of Meeker |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083221816 PECOS PAC ID: 0840109740 Enrollment ID: O20040216000811 |
| Mailing Address | Practice Location Address |
|---|---|
| Thad Peter Larson, CRNA 24967 545th Ave, Grove City, MN 56243-5603 Ph: (801) 836-8423 | Thad Peter Larson, CRNA 612 S Sibley Ave, Litchfield, MN 55355-3340 Ph: (320) 693-3242 |
Charles Fuller, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 612 S Sibley Ave, Litchfield, MN 55355 Phone: 320-693-3242 | |
Craig P Mckay, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 612 S Sibley Ave, Litchfield, MN 55355 Phone: 320-693-3242 | |
Barry R Rick, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 66649 305th St, Litchfield, MN 55355 Phone: 763-656-9001 | |
Tera L Bredeson, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 612 S Sibley Ave, Litchfield, MN 55355 Phone: 320-693-4500 |