Provider Demographics
NPI:1538031323
Name:BLAND, LARS (RN)
Entity type:Individual
Prefix:
First Name:LARS
Middle Name:
Last Name:BLAND
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 E ANOKA ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55803-2006
Mailing Address - Country:US
Mailing Address - Phone:608-469-2383
Mailing Address - Fax:
Practice Address - Street 1:244 E ANOKA ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55803-2006
Practice Address - Country:US
Practice Address - Phone:608-469-2383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2505282163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse