Individual
MARY ELIZABETH LAVALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
5501 N 19TH AVE STE 400, PHOENIX, AZ 85015-2456
(602) 249-9161
(602) 246-2853
Mailing address
5501 N 19TH AVE STE 400, PHOENIX, AZ 85015-2456
(602) 249-9161
(602) 246-2853
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP1091
AZ
Other
Enumeration date
09/26/2005
Last updated
11/25/2019
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