Andrea Larsen, RD
Dietitian, Registered in Bowling Green, KY. Individual provider (NPI-1).
NPI number1891461604
StatusActive
Last updated in NPPESAug 20, 2021
Details
- NPI
- 1891461604
- Entity type
- Individual (NPI-1)
- Name
- Andrea Larsen
- Credential
- RD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 20, 2021
- Certification date
- Aug 20, 2021
- Last updated
- Aug 20, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 251656 | KY | Yes |
Practice location
207 Traditions BlvdBowling Green, KY 42103-7957
Phone 270-901-3412 · Fax 270-901-3413
Mailing address
207 Traditions BlvdBowling Green, KY 42103-7957
Phone 270-901-3412 · Fax 270-901-3413
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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