Individual
KARI J LAVIGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201 CEDAR STREET, 6600, ALBUQUERQUE, NM 87106
(505) 724-4300
(505) 724-4384
Mailing address
700 LOMAS BLVD NE, 3 WOODWARD CENTER, ALBUQUERQUE, NM 87102-2568
(505) 242-1711
(505) 242-0189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2005-0028
NM
363AM0700X
Medical Physician Assistant
PA2005-0028
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90808053
—
NM
Enumeration date
05/03/2006
Last updated
03/17/2018
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