Healthcare Provider Details

I. General information

NPI: 1053154740
Provider Name (Legal Business Name): LAVONA DION MCKINNEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 E CENTER ST
LEXINGTON NC
27292-4402
US

IV. Provider business mailing address

1004 VENUS ST
KANNAPOLIS NC
28083-3722
US

V. Phone/Fax

Practice location:
  • Phone: 336-746-3500
  • Fax:
Mailing address:
  • Phone: 803-899-2102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5020303
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: