Individual
LARRY ANTHONY MORALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1233 N MAIN ST STE 1A, SAN LUIS, AZ 85336-0663
(928) 550-5514
(928) 550-5160
Mailing address
PO BOX 617, SOMERTON, AZ 85350-0617
(928) 315-7910
(928) 722-6113
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
247394
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083663
—
AZ
Enumeration date
09/16/2020
Last updated
08/24/2021
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