Provider Demographics
NPI:1841436722
Name:THOMPSON, LAVERNA KAYE (LVN)
Entity type:Individual
Prefix:MRS
First Name:LAVERNA
Middle Name:KAYE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 4 BOX 49017
Mailing Address - Street 2:
Mailing Address - City:ALTURAS
Mailing Address - State:CA
Mailing Address - Zip Code:96101-9518
Mailing Address - Country:US
Mailing Address - Phone:530-233-3549
Mailing Address - Fax:
Practice Address - Street 1:HC 4 BOX 49017
Practice Address - Street 2:
Practice Address - City:ALTURAS
Practice Address - State:CA
Practice Address - Zip Code:96101-9518
Practice Address - Country:US
Practice Address - Phone:530-233-3549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-26
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 190655164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAVN 190655OtherSTATE NURSING LICENSE NUMBER