Provider Demographics
NPI:1033760871
Name:LAWRENCE, SHERI LYNN
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:LYNN
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:IONE
Mailing Address - State:CA
Mailing Address - Zip Code:95640-5429
Mailing Address - Country:US
Mailing Address - Phone:209-304-0817
Mailing Address - Fax:
Practice Address - Street 1:5575 CARBONDALE RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:CA
Practice Address - Zip Code:95669-9729
Practice Address - Country:US
Practice Address - Phone:209-304-0817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider