Individual
WILLIAM T LAVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1507 SPRING STREET, JEFFERSONVILLE, IN 47130-3554
(812) 901-6881
(812) 218-9318
Mailing address
1507 SPRING STREET, JEFFERSONVILLE, IN 47130-3554
(812) 901-6881
(812) 218-9318
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3008244
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71004684A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063415297
GROUP NUMBER - PARK VIEW MD GROUP
—
01
—
1487872636
GROUP NUMBER - PARK VIEW ARNP GROUP
—
05
—
201198690
—
IN
Enumeration date
08/27/2013
Last updated
10/18/2024
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