Individual
MS. KATELINE LAVACHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
PROMENADE II 1230 PEACHTREE ST NE, 19TH FLOOR, ATLANTA, GA 30309-3574
(866) 949-0108
Mailing address
40 S MAIN ST STE 1300, MEMPHIS, TN 38103-5513
(866) 949-0108
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
477562-1
NY
363LF0000X
Family Nurse Practitioner
ARNP9197326
FL
363LF0000X
Family Nurse Practitioner
Primary
RN291455
GA
Other
Enumeration date
01/13/2014
Last updated
03/24/2022
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