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General NPI Number Information
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NPI Number | 1871720003
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Entity Type | Individual
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Provider Name | JOSEPH LAVALLO ACNP
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Gender | Male
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1267 HIGHWAY 54 W STE 4200
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-2112
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Country | US
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Telephone | 678-829-1060
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Fax | 678-829-1099
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Provider Business Mailing Address
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Address Line | 1800 HOWELL MILL RD NW STE 800
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City | ATLANTA
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State | GA
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Zip | 30318-0922
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Country | US
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Telephone | 678-298-3239
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN214862
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License Number State | GA
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