MRS. JAMIE P LARSEN PAC NPI 1659410983

NPI Information

NPI: 1659410983
Provider Name: MRS. JAMIE P LARSEN, PAC
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
2250 E GERMANN RD
STE 2
CHANDLER, AZ
ZIP 85286
Phone: (480) 878-5306
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MRS. Jamie P Larsen, PAC is a medical physician assistant in Chandler, AZ with 20 years of experience. MRS. Jamie P Larsen, PAC NPI is 1659410983. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2250 E GERMANN RD
STE 2
CHANDLER, AZ
ZIP 85286-575
Phone: (480) 878-5306

The NPI 1659410983 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/5/2007 and was last updated on 1/31/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VG0400X	Obstetrics & Gynecology	Gynecology	57597411206	UTAH	No
2	363AM0700X	Physician Assistant	Medical	5177	ARIZONA	Yes
3	363AM0700X	Physician Assistant	Medical	57597411206	UTAH	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	553068427005	MEDICAID	UTAH
2	Q39423	MEDICARE UPIN
3	Z197611	MEDICARE PIN	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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