Lavaque, Peter Charles

Lavaque, Peter Charles is an sole proprietor health care provider with primary practice located at 2627 Bay Settlement Rd , Green Bay WI 54311-7328. He recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as his primary health care specialty. Lavaque, Peter Charles can be contacted via phone (920) 227-7295.

Contact Information

Primary practice address
2627 Bay Settlement Rd Green Bay WI 54311-7328
Phone: (920) 227-7295
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X Wisconsin

Profile Details

NPI number 1649444738
LBN Legal business name Lavaque, Peter Charles
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 18th, 2008
Last updated Apr 18th, 2008 - about 16 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 1649444738 NPPES
Wisconsin MEDICAID 35051400

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