Crystal Larson
Home Health in Maple Grove, MN. Individual provider (NPI-1).
NPI number1861252082
StatusActive
Last updated in NPPESMar 22, 2024
Details
- NPI
- 1861252082
- Entity type
- Individual (NPI-1)
- Name
- Crystal Larson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 22, 2024
- Certification date
- Mar 22, 2024
- Last updated
- Mar 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251E00000X | Home Health | 414944 | MN | Yes |
| 374U00000X | Home Health Aide | 414944 | MN | |
| 376J00000X | Homemaker | 414944 | MN | |
| 376K00000X | Nurse's Aide | 414944 | MN | |
| 385H00000X | Respite Care | 414944 | – |
Practice location
11204 86th Ave NMaple Grove, MN 55369-4510
Phone 612-470-0105 · Fax 612-299-1425
Mailing address
14111 93rd Pl NMaple Grove, MN 55369-8912
Phone 612-670-2058 · Fax 612-299-1425
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