Individual
SHAWN ROBERT O'HAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AG-ACNP
Contact information
Practice address
84 ACOMA BLVD N STE 106, LAKE HAVASU CITY, AZ 86403-6096
(928) 412-8808
(928) 412-8807
Mailing address
84 ACOMA BLVD N STE 106, LAKE HAVASU CITY, AZ 86403-6096
(928) 412-8808
(928) 412-8807
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP11115
AZ
Other
Enumeration date
07/08/2016
Last updated
11/11/2021
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