Individual
SUSAN MARIA LAVELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
16319 THIRD STREET, GUERNEVILLE, CA 95446
(707) 869-2849
(707) 869-1477
Mailing address
8690 PETALUMA HILL RD, PENNGROVE, CA 94951-8734
(707) 992-0030
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
NP 17209
CA
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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