Provider Demographics
NPI:1740807502
Name:LAVERDURE PSYCHIATRY PLLC
Entity type:Organization
Organization Name:LAVERDURE PSYCHIATRY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DURWARD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:406-945-9019
Mailing Address - Street 1:311 3RD ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-3515
Mailing Address - Country:US
Mailing Address - Phone:406-945-9019
Mailing Address - Fax:406-945-9021
Practice Address - Street 1:311 3RD ST
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3515
Practice Address - Country:US
Practice Address - Phone:406-945-9019
Practice Address - Fax:406-945-9021
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAVERDURE PSYCHIATRY PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-28
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty