Individual
MISS STEPHANIE A LAVIGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
919 JASMINE ST, DENVER, CO 80220-4588
(303) 388-4256
Mailing address
919 JASMINE ST, DENVER, CO 80220-4588
(303) 388-4256
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002426
IA
363A00000X
Physician Assistant
Primary
4637
CO
363A00000X
Physician Assistant
5601007109
MI
Other
Enumeration date
07/19/2013
Last updated
09/25/2019
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