Healthcare Provider Details

I. General information

NPI: 1548848229
Provider Name (Legal Business Name): JESSICA LAVERGNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4220
US

IV. Provider business mailing address

DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE CAMPUS CAMPUS BOX #7525, BRINKHOUS-BULLITT BUILDING
CHAPEL HILL NC
27599-7525
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-1476
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number2026-02851
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: