Provider Demographics
NPI:1295200095
Name:LAWRENCE, VENICE HAY
Entity Type:Individual
Prefix:MRS
First Name:VENICE
Middle Name:HAY
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:VENICE
Other - Middle Name:LAWRENCE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6604 NW 28TH TERR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653
Mailing Address - Country:US
Mailing Address - Phone:352-301-0249
Mailing Address - Fax:
Practice Address - Street 1:6604 NW 28TH TERR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653
Practice Address - Country:US
Practice Address - Phone:352-301-0249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA324847374U00000X, 376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker