Individual
LARRY LAWAYNE MINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
4169 E CHOLLA CANYON DR, PHOENIX, AZ 85044-6712
(480) 495-5940
Mailing address
4169 E CHOLLA CANYON DR, PHOENIX, AZ 85044-6712
(480) 495-5940
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP10495
AZ
Other
Enumeration date
10/18/2017
Last updated
10/28/2017
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