Doctor Name: | AMY M. LAVIN |
NPI Number: | 1134479421 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APNP |
License Number: | 5026-33 |
Business Practice Address: | 240 Maple St Woodruff, WI - 545689190 |
Business Phone Number: | 7153568920 |
Business Fax Number: | |
Mailing Address: | 240 Maple St, WOODRUFF |
State: | WI |
Postal Code: | 545689190 |
Phone Number: | 7153568920 |
Fax Number: | |
NPI Enumeration Date: | 09/13/2012 |
NPI Last Update Date: | 09/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5026-33 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |