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Individual
JILL LAVELLA
Active
Individual
JILL LAVELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP034247L
PA
183500000X
Pharmacist
RP1003049
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP034247L
PHARMACIST LICENSE
PA
01
—
RP1003049
AUTHORIZATION TO ADMINISTER INJECTABLES
PA
Enumeration date
06/21/2018
Last updated
01/13/2022
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