Provider Demographics
NPI:1821520818
Name:EVERETT, LAVETTE D (CNA)
Entity Type:Individual
Prefix:
First Name:LAVETTE
Middle Name:D
Last Name:EVERETT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8715 NORFOLK BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-1915
Mailing Address - Country:US
Mailing Address - Phone:904-438-9732
Mailing Address - Fax:
Practice Address - Street 1:8715 NORFOLK BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-1915
Practice Address - Country:US
Practice Address - Phone:904-438-9732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide