Provider Demographics
NPI:1326061888
Name:LAWRENCE, SHARON B (MPA, RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:B
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MPA, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 DALEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-1605
Mailing Address - Country:US
Mailing Address - Phone:423-629-9801
Mailing Address - Fax:
Practice Address - Street 1:1500 DALEWOOD DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-1605
Practice Address - Country:US
Practice Address - Phone:423-629-9801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000000178133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered