Eddy, Lavonne

Eddy, Lavonne is an individual health care provider with primary practice located at 315 W Old Key Dr , Peru IN 46970-9057. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Eddy, Lavonne can be contacted via phone (765) 475-6963.

Contact Information

Primary practice address
315 W Old Key Dr Peru IN 46970-9057
Phone: (765) 475-6963
Fax: (765) 475-2833
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71000301 Indiana

Profile Details

NPI number 1730266602
LBN Legal business name Eddy, Lavonne
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2006
Last updated Oct 15th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730266602 NPPES
Indiana MEDICAID 200375930

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