Provider Demographics
NPI:1912403676
Name:LAVENDER, AYVEE (FNP-C)
Entity Type:Individual
Prefix:
First Name:AYVEE
Middle Name:
Last Name:LAVENDER
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 1:6805 DWIGHT ROWLAND RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:27592-0105
Mailing Address - Country:US
Mailing Address - Phone:919-737-2561
Mailing Address - Fax:828-800-9712
Practice Address - Street 1:6805 DWIGHT ROWLAND RD
Practice Address - Street 2:
Practice Address - City:WILLOW SPRING
Practice Address - State:NC
Practice Address - Zip Code:27592-0105
Practice Address - Country:US
Practice Address - Phone:919-737-2561
Practice Address - Fax:828-800-9712
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136033363LF0000X
IAA166587363LF0000X
NC5015429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily