Individual
GREG ERIC LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
624 S 1000 E STE 103, ST GEORGE, UT 84790-5902
(435) 652-1135
(435) 652-1190
Mailing address
624 S 1000 E STE 103, ST GEORGE, UT 84790-5902
(435) 652-1135
(435) 652-1190
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
354177-4405
UT
363LF0000X
Family Nurse Practitioner
354177-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578879441
—
UT
Enumeration date
08/29/2010
Last updated
05/21/2024
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