Individual
MS. MICHELLE MADELINE LAVELLE-HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
6521 MCCAULEY, EDINA, MN 55439-1028
(952) 942-7569
(612) 273-9945
Mailing address
6521 MCCAULEY, EDINA, MN 55439-1028
(952) 942-7569
(612) 273-9945
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R953047
MN
Other
Enumeration date
01/09/2006
Last updated
07/30/2012
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