Individual
GREGORY ALLEN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1233 N MAIN ST, STE 1A, SAN LUIS, AZ 85349
(928) 550-5514
(928) 722-6113
Mailing address
PO BOX 617, SOMERTON, AZ 85350-0617
(928) 236-8001
(928) 722-6113
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2973
MN
363LF0000X
Family Nurse Practitioner
Primary
AP2705
AZ
Other
Enumeration date
02/08/2006
Last updated
04/01/2019
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