Stephen Larson, CRNA in Antigo, WI - Nurse Anesthetist, Certified Registered

Stephen Larson, CRNA is a Nurse Anesthetist, Certified Registered based in Antigo, Wisconsin. Stephen Larson is licensed to practice in Wisconsin (license number 202157-30) and his current practice location is 112 E 5th Ave, Antigo, Wisconsin. He can be reached at his office (for appointments etc.) via phone at (715) 623-2331.

NPI number for Stephen Larson is 1568465201 and his current mailing address is 1752 Edgewood Rd, Winona, Minnesota. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1568465201.

Contact Information

	Stephen Larson, CRNA
	112 E 5th Ave, Antigo, WI 54409-2710
	(715) 623-2331
	Not Available

Provider's Profile

Full Name	Stephen Larson
Gender	Male
Speciality	Nurse Anesthetist, Certified Registered
Location	112 E 5th Ave, Antigo, Wisconsin
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1568465201
Provider Enumeration Date: 05/26/2005
Last Update Date: 04/16/2014

Medical Identifiers

Medical identifiers for Stephen Larson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568465201	NPI	-	NPPES
1882	Other		IBAX
136542800	Medicaid	MN
52D0662095	Other		CLIA
43293000	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	R-081276-4 (Minnesota)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	202157-30 (Wisconsin)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stephen Larson is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Stephen Larson, CRNA 1752 Edgewood Rd, Winona, MN 55987-2149 Ph: () -	Stephen Larson, CRNA 112 E 5th Ave, Antigo, WI 54409-2710 Ph: (715) 623-2331

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Nurse Anesthetist, Certified Registered Nurses in Antigo, WI

Todd E. Anderson, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 112 E 5th Ave, Antigo, WI 54409 Phone: 715-623-2331
Stephen M. Kordiyak, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 115 E 5th Ave, Antigo, WI 54409 Phone: 715-623-2331

Stephen Larson, CRNA - Nurse Anesthetist, Certified Registered in Antigo, WI