Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 7748 | CT |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 7748 | CT |
NPI | 1356837108 |
---|---|
Provider Name | Kimberly A Lavoie |
First Address | New Haven, CT 06510-3220 |
Second Address | New Haven, CT 06510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2018 |
Last Update Date | 08/08/2018 |