Jimmie Joann Larson Pc | |
1100 N Lincoln Ave Ste F York NE 68467-1743 | |
(402) 759-3802 | |
(402) 759-3803 |
Full Name | Jimmie Joann Larson Pc |
---|---|
Speciality | Counselor |
Location | 1100 N Lincoln Ave Ste F, York, Nebraska |
Authorized Official Name and Position | Jimmie Larson (PRESIDENT) |
Authorized Official Contact | 4023665432 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jimmie Joann Larson Pc 1100 N Lincoln Ave Ste F York NE 68467-1743 Ph: (402) 759-3802 | Jimmie Joann Larson Pc 1100 N Lincoln Ave Ste F York NE 68467-1743 Ph: (402) 759-3802 |
NPI Number | 1295473346 |
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Provider Enumeration Date | 05/26/2022 |
Last Update Date | 11/30/2023 |
Certification Date | 11/30/2023 |
Medicare PECOS PAC ID | 6002251329 |
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Medicare Enrollment ID | O20240227000982 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295473346 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Jimmie Jo Ann Larson |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1942948187 PECOS PAC ID: 8729423041 Enrollment ID: I20240227001537 |
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