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Individual

SUSAN J LAVELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, DNP

Contact information

Practice address
401 PHALEN BLVD, SAINT PAUL, MN 55130-5302
(651) 254-7870
Mailing address
6714 OAKLAND AVE, RICHFIELD, MN 55423-2554
(612) 861-8136

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2045
MN
363LW0102X
Women's Health Nurse Practitioner
R1171970
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07-00900
MEDICA
01
1017714
PREFERRED ONE
01
1069672
AMERICA'S PPO (ARAZ)
01
111465
UCARE
01
21274
SIOUX VALLEY HEALTH PLAN
01
5K123LA
BCBS MN
MN
05
904718200
MN
01
HP18165
HEALTH PARTNERS
Enumeration date
01/25/2006
Last updated
09/27/2023
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