Individual
DIANNE H LAVELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
5201 GATE PKWY, JACKSONVILLE, FL 32256-7284
(904) 645-4060
Mailing address
4181 TRADEWINDS DR, JACKSONVILLE, FL 32250-1820
(973) 349-4002
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN9374577
FL
Other
Enumeration date
09/13/2012
Last updated
10/07/2020
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