GREGORY ALLEN LARSON (NPI# 1578536892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578536892 |
| Entity Type | Individual |
| Full Name | GREGORY ALLEN LARSON |
| Credential | FNP-BC |
| Practice Address |
1233 N Main St Ste 1a San Luis AZ 85349 |
| Mailing Address |
Po Box 617 Somerton AZ 85350-0617 |
| Practice Telephone | 9285505514 |
| Practice Fax Number | 9287226113 |
| Mailing Telephone | 9282368001 |
| Mailing Fax Number | 9287226113 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2019-04-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
2973 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP2705 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1233 N Main St, Ste 1a, San Luis, AZ 85349 | 9285505514 | 9287226113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144775297 | Gregory Larson | Behavioral Analyst | 5803 W Craig Rd, 105, Las Vegas, NV 89130-2536 | 2016-08-18 |
| 1134577448 | Gregory Larson | Physician Assistant | 550 E Colorado Blvd, Spearfish, SD 57783-2776 | 2016-05-26 |
| 1790974764 | Gregory Thomas Larson | Community Health Worker | 167 Ne Kamiaken St, (mezzanine), Pullman, WA 99163-2611 | 2007-10-16 |
| 1174730618 | Gregory Richard Larson | Psychologist | 333 Estudillo Ave, #207, San Leandro, CA 94577-4717 | 2007-05-16 |
| 1295793875 | Gregory Larson | Spec/Tech, Pathology | 40520 Co Hwy 34, White Earth Health Center, Ogema, MN 56569 | 2006-05-03 |
| 1629036645 | Gregory R. Larson | Family Medicine | 511 14th Ave Ne, Watertown, SD 57201-6811 | 2006-05-01 |
| Street Address |
1233 N MAIN ST STE 1A |
| City | SAN LUIS |
| State | AZ |
| Zip Code | 85349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871040436 | South County Diagnostic Services, LLC | Radiology | 1233 N Main St, Ste 1b, San Luis, AZ 85349 | 2016-09-01 |
| 1114033479 | Armik Ohanesyan Salmas | Durable Medical Equipment & Medical Supplies | 1233 N Main St, Ste 4, San Luis, AZ 85349 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598391351 | Bryson Lee Wandling | Physician Assistant | 815 E. Cesar Chavez Blvd., San Luis, AZ 85349 | 2020-03-12 |
| 1306482377 | Cecilia Denise Zepeda | Registered Nurse | 1250 N. 8th Avenue, San Luis, AZ 85349 | 2019-11-25 |
| 1184142317 | Rosenda Uribe | Specialist/Technologist | 337 Adobe St, San Luis, AZ 85349 | 2017-09-08 |
| 1033644372 | Lourens Rasmus Botha | Pharmacist | 1613 N Main Street, San Luis, AZ 85349 | 2017-04-24 |
| 1205389988 | Miriam Gonzalez | Dentist | 801 North 2nd Ave, San Luis, AZ 85349 | 2016-07-28 |
| 1386016269 | Isabel M Arias | Dental Hygienist | 1896 E. Babbitt Ln., San Luis, AZ 85349 | 2015-10-30 |
| 1801262308 | Rosario Alejandra Morales Villegas | Specialist/Technologist | 1657 E. B Street, San Luis, AZ 85349 | 2015-08-19 |
| 1598142291 | Manuel Angel Salcido | Specialist/Technologist, Other | 1959 E Georgina St, San Luis, AZ 85349 | 2015-05-01 |
| 1508269465 | Christina Mclean | Registered Nurse | 1250 N. 8 Ave., San Luis, AZ 85349 | 2014-10-06 |
| 1134542921 | Gerardo Garcia | Pharmacist | 1613 N Main St, San Luis, AZ 85349 | 2014-01-29 |
| Find all providers in zip 85349 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386287753 | San Jose Integrated Clinic LLC | Nurse Practitioner | 2000 E Juan Sanchez Blvd, San Luis, AZ 85336-0481 | 2019-10-17 |
| 1992160329 | Patricia Rodriguez, Fnp-c & Associates | Nurse Practitioner | 1950 Juan Sanchez Blvd, Suite F, San Luis, AZ 85349-6805 | 2015-12-30 |
| 1699904334 | Fsp Health Ministries | Nurse Practitioner | 1914 E. Juan Sanchez Blvd, Suite 2, San Luis, AZ 85349 | 2009-07-02 |
| 1154546810 | Fsp Health Ministries | Nurse Practitioner | 780 N Cesar Chavez St, San Luis, AZ 85349 | 2007-04-16 |
| 1851413231 | Steven Lee Covington | Nurse Practitioner | 1896 E Babbitt Ln, San Luis, AZ 85349 | 2007-04-04 |
| 1740367374 | Rodolfo Valenzuela Iv | Nurse Practitioner | 1914 E. Juan Sanchez Blvd., 2, San Luis, AZ 85349-6805 | 2006-11-01 |
| 1790775567 | Emelin Martinez | Nurse Practitioner | North Highway 159, San Luis, CO 81152 | 2005-10-24 |
| 1063958676 | Adlene Joseph | Nurse Practitioner | 1896 E Babbitt Ln, San Luis, AZ 85349 | 2017-01-06 |
| 1356894240 | Clarisse Ngueha-nana | Nurse Practitioner | 1896 E Babbitt Ln, San Luis, AZ 85349-7613 | 2016-07-27 |
| 1770917429 | Gina Botello | Nurse Practitioner | 1896 E Babbit Ln, San Luis, AZ 85349 | 2013-08-29 |
| Find all providers in SAN LUIS | ||||
Please comment or provide details below to improve the information on GREGORY ALLEN LARSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.