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Individual

LAVY HENG CLEVENGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6000
(864) 560-4023
Mailing address
PO BOX 277723, ATLANTA, GA 30384-7723
(864) 560-4123
(864) 560-4023

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
25572
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP8658
SC
01
SCN2673365
MEDICARE PIN
SC
01
SCN2679225
MEDICARE PIN
SC
01
SCN267O696
MEDICARE PIN
SC
Enumeration date
11/17/2021
Last updated
05/06/2024
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