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Individual
LAVONNE HAIRSTON
Active
Individual
LAVONNE HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101258295
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
0101258295
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710272323
—
VA
05
—
INTERN
—
LA
Enumeration date
06/10/2011
Last updated
01/10/2022
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