Provider Demographics
NPI:1215228879
Name:LAVINUS, PATRICIA HARDY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:HARDY
Last Name:LAVINUS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11102 RABBIT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-8923
Mailing Address - Country:US
Mailing Address - Phone:804-748-8175
Mailing Address - Fax:
Practice Address - Street 1:11102 RABBIT RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23838-8923
Practice Address - Country:US
Practice Address - Phone:804-387-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily