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General NPI Number Information
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NPI Number | 1942174180
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Entity Type | Individual
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Provider Name | LYLE LARSON MSN, APRN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 2960 SUNRIDGE HEIGHTS PKWY
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City | HENDERSON
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State | NV
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Zip | 89052-4462
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Country | US
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Telephone | 725-291-5900
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Fax | 725-291-5901
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Provider Business Mailing Address
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Address Line | 2345 VIA INSPIRADA STE 100-165
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City | HENDERSON
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State | NV
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Zip | 89044-1848
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 866927
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License Number State | NV
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