Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeannie Therese Larson, MD

Individual provider Dermatology Physician · NPI 1164406369

Jeannie Therese Larson, MD is a Dermatology in Maple Grove, Minnesota. Graduated from University of Minnesota Medical School in 1985, 41 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
41
Trained at
University of Minnesota Medical School
Licensed in
MN
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9555 Upland Ln N
Maple Grove, MN 55369
Phone: (952) 993-3260
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence 33568 (MN)
Dermatology Physician Taxonomy 207N00000X · Licence 33568 (MN)

Record details

NPI number1164406369
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 1, 2005
Last updated in NPPESAugust 14, 2020
Certification dateAugust 14, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 1985 (41 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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