Provider Demographics
NPI:1831417161
Name:LAVY, ABIGAIL ADAMS NIMS (FNP-C)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ADAMS NIMS
Last Name:LAVY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ELK RUN DR STE 101
Mailing Address - Street 2:
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621-9244
Mailing Address - Country:US
Mailing Address - Phone:970-927-8181
Mailing Address - Fax:
Practice Address - Street 1:100 ELK RUN DR STE 101
Practice Address - Street 2:
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-9244
Practice Address - Country:US
Practice Address - Phone:970-927-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO127043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily