Provider Demographics
NPI:1215483375
Name:LAVALLEE, DAYNA
Entity type:Individual
Prefix:MRS
First Name:DAYNA
Middle Name:
Last Name:LAVALLEE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DAYNA
Other - Middle Name:
Other - Last Name:LINDENFELSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:401 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-4516
Mailing Address - Country:US
Mailing Address - Phone:432-582-2280
Mailing Address - Fax:
Practice Address - Street 1:401 E 6TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4516
Practice Address - Country:US
Practice Address - Phone:432-582-2280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant