Provider Demographics
NPI:1154648384
Name:LAWRENCE, ELIZABETH NICOLL (RN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:NICOLL
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 PLEASANT RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WEST HURLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12491
Mailing Address - Country:US
Mailing Address - Phone:845-679-4882
Mailing Address - Fax:
Practice Address - Street 1:29 PLEASANT RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:WEST HURLEY
Practice Address - State:NY
Practice Address - Zip Code:12491
Practice Address - Country:US
Practice Address - Phone:914-466-3553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY618719163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse