Individual
MICHELLE LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
161 E RIVULON BLVD, GILBERT, AZ 85297-0035
(480) 494-2465
Mailing address
3751 E ROBERT ST, GILBERT, AZ 85295-0014
(714) 743-5146
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
247565
AZ
363LF0000X
Family Nurse Practitioner
Primary
247565
AZ
Other
Enumeration date
09/19/2023
Last updated
11/30/2023
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