Provider Demographics
NPI:1821361973
Name:LAVENTURE, IRENE A (NP-C)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:A
Last Name:LAVENTURE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 S BURRO CANYON PL
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-7938
Mailing Address - Country:US
Mailing Address - Phone:520-820-0971
Mailing Address - Fax:
Practice Address - Street 1:2800 EAST AJO WAY
Practice Address - Street 2:UNIVERSITY OF ARIZONA MEDICAL CENTER - SOUTH CAMPUS
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713
Practice Address - Country:US
Practice Address - Phone:520-874-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01820363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily