Female

Jennine Larson M.D.

Surgery Physician in Wausau, WI(View on Map)

Full Name

Jennine Larson M.D.

NPI Number

1942412044

NPI Type

Individual Provider

Gender

Female

Enumeration Date

05/03/2007

Specialties

(Taxonomies)

Code

208600000X
2086S0127X

Primary Taxonomy

Yes
No

Licenses

State

Wisconsin

License Number

51726

Contact
Information

Purpose

Mailing
Location

Address

2400 PINE RIDGE BLVD
2400 PINE RIDGE BLVD

City

Wausau
Wausau

State

WI
WI

Postal Code

54401-7803
54401-7803

Country

US
US

Telephone Number

(715) 847-2022
(715) 847-2022

Identifiers

Identifier

35352800

Identifier State

WI

Identifier Issuer

Unknown

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

Data last updated by provider on 01/04/2021

Provider Address

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