Male or Other

Larry Nilsson PA-C

Physician Assistant in Edina, MN(View on Map)

Full Name

Larry Nilsson PA-C

NPI Number

1033197595

NPI Type

Individual Provider

Gender

Male

Enumeration Date

01/05/2006

Specialties

(Taxonomies)

Code

363A00000X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

9754

Contact
Information

Purpose

Mailing
Location

Address

4200 DAHLBERG DR
4010 WEST 65TH STREET

City

Golden Valley
Edina

State

MN
MN

Postal Code

55422-4840
55435-4800

Country

US
US

Telephone Number

(952) 456-7000
(952) 944-2519

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/16/2015

Provider Address

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