Provider Demographics
NPI:1467252353
Name:LAVEZZO, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LAVEZZO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7185 HARBOUR TOWNE PKWY S STE 108
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3796
Mailing Address - Country:US
Mailing Address - Phone:757-541-1499
Mailing Address - Fax:
Practice Address - Street 1:7185 HARBOUR TOWNE PKWY S STE 108
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3796
Practice Address - Country:US
Practice Address - Phone:757-541-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001259262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily