Provider Demographics
NPI:1528197977
Name:LAVES, MARY A (RN, APN-BC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:A
Last Name:LAVES
Suffix:
Gender:F
Credentials:RN, APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 OSBORNE CT
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-6020
Mailing Address - Country:US
Mailing Address - Phone:732-356-0226
Mailing Address - Fax:
Practice Address - Street 1:224 OSBORNE CT
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-6020
Practice Address - Country:US
Practice Address - Phone:732-356-0226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN64585363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health