Individual
REGINA LAVELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 662-8298
Mailing address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 662-8298
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN519814L
PA
Other
Enumeration date
11/03/2015
Last updated
11/03/2015
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