OrganizationActive
Innovative Health Care of Havasu LLC
NPI 1114230893 · Family Health Clinical Nurse Specialist · Lake Havasu City, AZ
Provider details
- NPI number
- 1114230893
- Entity type
- Organization
- Primary specialty
- Family Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Summer Tilgner, Owner(928) 854-7666
- License
- AP3726 (AZ)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
297 Lake Havasu Ave South
Suite 200
Lake Havasu City, AZ 86403
Phone: (928) 854-7666
Fax: (928) 854-7660
Approximate (ZIP-level) locationGet directions
Mailing address
297 Lake Havasu Ave South
Lake Havasu City, AZ 86403
Registry dates
- Enumerated
- 2010-07-22
- Last updated
- 2018-05-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.