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Deactivated NPI 1285607853 Deactivated / Inactive NPI Female Practitioner

Jacqueline Emily Larson , CPNP

Nurse Practitioner - Pediatrics • Minnetonka, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jacqueline Larson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 13, 2006
NPI Deactivation Date May 09, 2017
Total Practice Duration ~11 Years of Practice (2006 – 2017)

Professional Overview & Biography Verified Profile Summary

Jacqueline Larson, CPNP was a registered Nurse Practitioner - Pediatrics practicing in Minnetonka, MN. Throughout an active medical career spanning 11 years, Jacqueline Larson provided care at the practice location at 17705 HUTCHINS DR until profile deactivation on 2017-05-09.

Practice Location & Contact Primary Location

Practice Address

17705 Hutchins Dr
Suite 101

Minnetonka, MN 553454145

Telephone 9524018300
Associated Practice Facility / Clinic
🏢 South Lake Clinic, P.a. Facility NPI 1427027184

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Minnetonka, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 5.0 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
20 Specialists

Practicing in Minnetonka, MN (480 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License MN R0573051

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Stephanie Sperl , MSN, APRN, CPNP-PC

Nurse Practitioner - Pediatrics

NPI 1093276172

Master of Science in Nursing, Advanced Practice Registered Nurse, CPNPPC

Andrea Gravley , CPNP

Nurse Practitioner - Pediatrics

NPI 1104074434

Certified Pediatric Nurse Practitioner

NPI 1134191901

Doctor of Medicine (M.D.)

Lynnea Piotter , PNP

Registered Nurse

NPI 1134264161

Pediatric Nurse Practitioner

NPI 1154393304

Doctor of Medicine (M.D.)

NPI 1154594109

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 09, 2017

Record deactivated on May 09, 2017

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 17705 HUTCHINS DR, SUITE 101, MINNETONKA, MN 553454145 (Tel: 9524018300)

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Updated Business Mailing Address July 09, 2007

Registered at 17705 HUTCHINS DR STE 101, MINNETONKA, MN 553454102 (Tel: 9524018300)

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Provider Name / Credentials Updated July 09, 2007

Recorded as JACQUELINE LARSON, CPNP

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Nurse Practitioner (License #R0573051 in MN)

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Initial NPI Registration & Enumeration February 13, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1285607853
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 13, 2006
Last Update: July 09, 2007
Deactivation Date: May 09, 2017

Mailing Address

17705 Hutchins Dr Ste 101

Minnetonka, MN 553454102

Phone: 9524018300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.