Jacqueline Emily Larson , CPNP
Nurse Practitioner - Pediatrics • Minnetonka, MN
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.
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
17705 Hutchins Dr
Suite 101
Minnetonka, MN 553454145
Specialty Benchmarks & Practice Insights
Comparative analytics for Nurse Practitioner - Pediatrics in Minnetonka, MN
Practicing in Minnetonka, MN (480 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 363LP0200X
Definition to come...
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Nurse Practitioner - Pediatrics
Master of Science in Nursing, Advanced Practice Registered Nurse, CPNPPC
Nurse Practitioner - Pediatrics
Certified Pediatric Nurse Practitioner
Pediatrics
Doctor of Medicine (M.D.)
Registered Nurse
Pediatric Nurse Practitioner
Pediatrics
Doctor of Medicine (M.D.)
Pediatrics
Doctor of Medicine (M.D.)
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on May 09, 2017
NPI status registered as active in NPPES database
Registered at 17705 HUTCHINS DR, SUITE 101, MINNETONKA, MN 553454145 (Tel: 9524018300)
Registered at 17705 HUTCHINS DR STE 101, MINNETONKA, MN 553454102 (Tel: 9524018300)
Recorded as JACQUELINE LARSON, CPNP
Nurse Practitioner (License #R0573051 in MN)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
17705 Hutchins Dr Ste 101
Minnetonka, MN 553454102
Phone: 9524018300
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