Doctor Name: | JENNIFER LAWRENCE |
NPI Number: | 1114277803 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 2005022001 |
Business Practice Address: | 500 Russell St Kennett, MO - 638572102 |
Business Phone Number: | 5737171332 |
Business Fax Number: | 5737171335 |
Mailing Address: | 420 Line St, NEW MADRID |
State: | MO |
Postal Code: | 638691734 |
Phone Number: | 5737482404 |
Fax Number: | 5737488929 |
NPI Enumeration Date: | 09/11/2012 |
NPI Last Update Date: | 09/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2005022001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |