Provider Demographics
NPI:1780891044
Name:LAHAIE, YVONNE (NP)
Entity type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:
Last Name:LAHAIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 FERNVIEW TRL
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-4730
Mailing Address - Country:US
Mailing Address - Phone:804-614-2355
Mailing Address - Fax:
Practice Address - Street 1:701 E BYRD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-3921
Practice Address - Country:US
Practice Address - Phone:804-687-8407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017139050363L00000X
VA0024167608207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine