IndividualActive
Larry Bousquet, FNP
NPI 1205544871 · Nurse Practitioner · Fort Mohave, AZ
Provider details
- NPI number
- 1205544871
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- FNP
- Sex
- Male
- Sole proprietor
- No
- License
- 283825 (AZ)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1611 E Joy Ln # 1
Fort Mohave, AZ 86426-8807
Phone: (928) 768-9496
Fax: (928) 768-1943
Approximate (ZIP-level) locationGet directions
Mailing address
1611 E Joy Ln
Fort Mohave, AZ 86426-8807
Registry dates
- Enumerated
- 2022-11-11
- Last updated
- 2022-11-11
- Certified
- 2022-09-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.