Individual
LAVONNE EDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
315 W OLD KEY DR, PERU, IN 46970-9057
(765) 475-6963
(765) 475-2833
Mailing address
315 W OLD KEY DR, PERU, IN 46970-9057
(765) 475-6963
(765) 475-2833
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000301
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200375930
—
IN
Enumeration date
10/31/2006
Last updated
10/15/2014
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