Provider Demographics
NPI:1063681062
Name:LAWRENCE, MARIA R (NP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:R
Last Name:LAWRENCE
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Gender:F
Credentials:NP
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Mailing Address - Street 1:400 N PEPPER AVE
Mailing Address - Street 2:CENTER FOR EMPLOYEE HEALTH AND WELLNESS
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-1801
Mailing Address - Country:US
Mailing Address - Phone:909-580-1701
Mailing Address - Fax:909-580-1359
Practice Address - Street 1:400 N PEPPER AVE
Practice Address - Street 2:CENTER FOR EMPLOYEE HEALTH AND WELLNESS
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-1801
Practice Address - Country:US
Practice Address - Phone:909-580-1701
Practice Address - Fax:909-580-1359
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA240417363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily