NPI 1700867397 · live from the CMS NPI Registry
Lavonne M Charbonneau, PA-C
Physician Assistant in Rolla, ND. National Provider Identifier 1700867397, active.
NPI record
| NPI | 1700867397 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 114 3rd St Ne, Rolla, ND 58367 |
| Practice phone | 701-477-3111 |
| Mailing address | Po Box 699, 114 Ne 3rd St, Rolla, ND 58367 |
| Enumerated | November 10, 2005 |
| Last updated | February 18, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | PAC0002 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.