Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Innovative Primary Care Clinic of Havasu PLLC

Organization Primary Care Nurse Practitioner · NPI 1588097349

Innovative Primary Care Clinic of Havasu PLLC is a Primary Care Nurse Practitioner in Lake Havasu City, Arizona. Licensed in Arizona. Registered with an NPI since 2013.

Licensed in
AZ
In the registry since
2013
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

297 Lake Havasu Ave S Ste 106
Lake Havasu City, AZ 86403-6526
Phone: (928) 854-7666
Fax: (928) 854-7660
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence AP1654 (AZ)

Record details

NPI number1588097349
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacquelyn Meyer — President · (928) 854-7666
NPI enumeratedAugust 15, 2013
Last updated in NPPESAugust 16, 2013
Mailing addressPo Box 27340, Phoenix, AZ 85061-7340

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