Provider Demographics
NPI:1073084992
Name:LAVIOLETTE, CYNTHIA LASHLEE WARNER (MPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LASHLEE WARNER
Last Name:LAVIOLETTE
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5312 MEMPHIS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-1736
Mailing Address - Country:US
Mailing Address - Phone:504-650-2414
Mailing Address - Fax:
Practice Address - Street 1:200 HENRY CLAY AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5798
Practice Address - Country:US
Practice Address - Phone:504-896-9732
Practice Address - Fax:504-896-9362
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2019-07-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty