Individual
LAVINIA CHALLENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
11838 SIERRA RD, VICTORVILLE, CA 92392-2141
(916) 712-4036
Mailing address
11838 SIERRA RD, VICTORVILLE, CA 92392-2141
(916) 712-4036
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
95016513
CA
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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