Heather Larson, | |
701 Hewitt Blvd, Red Wing, MN 55066-2848 | |
(651) 267-5000 | |
Not Available |
Full Name | Heather Larson |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 701 Hewitt Blvd, Red Wing, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306319512 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 3640 (Minnesota) | Primary |
Provider Name | Mayo Clinic Health System-lake City |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1164463659 PECOS PAC ID: 1951213487 Enrollment ID: O20031104000095 |
Provider Name | Mayo Clinic Health System-southeast Minnesota Region |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1891701637 PECOS PAC ID: 4385556703 Enrollment ID: O20031104000408 |
Mailing Address | Practice Location Address |
---|---|
Heather Larson, 701 Hewitt Blvd, Red Wing, MN 55066-2848 Ph: (651) 267-5489 | Heather Larson, 701 Hewitt Blvd, Red Wing, MN 55066-2848 Ph: (651) 267-5000 |
Nancy Ronae Olson, RN DIETITION Dietitian Medicare: Medicare Enrolled Practice Location: 701 Hewitt Blvd, Red Wing, MN 55066 Phone: 651-267-5000 | |
Joseph Gonzales, RD Dietitian Medicare: Medicare Enrolled Practice Location: 701 Hewitt Blvd, Red Wing, MN 55066 Phone: 651-267-5489 | |
Kathy M Boos, RN DIETITION Dietitian Medicare: Not Enrolled in Medicare Practice Location: 701 Fairview Blvd, Red Wing, MN 55066 Phone: 651-267-5000 | |
Mrs. Elizabeth Ann Knapp, MBA, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 701 Hewitt Blvd, Red Wing, MN 55066 Phone: 651-267-5480 |