| NPI | 1316976962 |
|---|---|
| Former Name | LAVONNE LYNN FUNK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP007903) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R161084) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-12-20 |