Provider Demographics
NPI:1548390529
Name:LAVASSEUR, NANCY GAIL (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:GAIL
Last Name:LAVASSEUR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1905 N OCEAN BLVD
Mailing Address - Street 2:#2E
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33305-3747
Mailing Address - Country:US
Mailing Address - Phone:954-630-3784
Mailing Address - Fax:
Practice Address - Street 1:600 S DIXIE HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-6034
Practice Address - Country:US
Practice Address - Phone:561-955-6025
Practice Address - Fax:561-955-6069
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP 3384352363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health