Individual
GEORGE LAVALLIERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 ELLIOT WAY, SUITE 200, MANCHESTER, NH 03103-3502
(603) 663-2315
(603) 647-9180
Mailing address
1 ELLIOT WAY, SUITE 200, MANCHESTER, NH 03103-3502
(603) 663-2315
(603) 647-9180
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
035281-23-11
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035281-21
REGISTERED NURSE LICENSE
NH
01
—
035281-23-11
ARNP - CRNA LICENSE
NH
Enumeration date
08/16/2005
Last updated
01/20/2023
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