Provider Demographics
NPI:1093186918
Name:LAWRENCE, CHRISTINE (LPN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 WALLACE AVE
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-3225
Mailing Address - Country:US
Mailing Address - Phone:419-617-2626
Mailing Address - Fax:
Practice Address - Street 1:143 WALLACE AVE
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-3225
Practice Address - Country:US
Practice Address - Phone:419-617-2627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.159800-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse