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Individual
MATTHEW THOMAS LAVELLE
Active
Individual
MATTHEW THOMAS LAVELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
SPO15635
PA
364SA2200X
Adult Health Clinical Nurse Specialist
SPO15635
PA
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
SPO15635
PA
Other
Enumeration date
02/01/2016
Last updated
03/08/2024
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