Individual
KIRANA LYNN LAVALLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2679 MAIN ST, CROWN POINT, NY 12928-2603
(518) 597-3029
Mailing address
2679 MAIN ST, CROWN POINT, NY 12928-2603
(518) 597-3029
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
101-0136759
VT
363L00000X
Nurse Practitioner
350495
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/06/2022
Last updated
03/16/2024
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