Provider Demographics
NPI:1093892903
Name:LAWLER, LAUREE BETH (CNP)
Entity Type:Individual
Prefix:MS
First Name:LAUREE
Middle Name:BETH
Last Name:LAWLER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:LAUREE
Other - Middle Name:BETH
Other - Last Name:SIPPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:979 CONGRESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4009
Mailing Address - Country:US
Mailing Address - Phone:937-435-9013
Mailing Address - Fax:937-435-1458
Practice Address - Street 1:979 CONGRESS PARK DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4009
Practice Address - Country:US
Practice Address - Phone:937-435-9013
Practice Address - Fax:937-435-1458
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-194868163W00000X
OHNP-06894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2372463Medicaid
OH2372463Medicaid
OHSINP76782OtherMEDICARE ID #