Provider Demographics
NPI:1326356171
Name:MCLAWRENCE, KENISHA RANJANA (LPN)
Entity Type:Individual
Prefix:
First Name:KENISHA
Middle Name:RANJANA
Last Name:MCLAWRENCE
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 1:199 GELSTON AVE
Mailing Address - Street 2:APT C6
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7057
Mailing Address - Country:US
Mailing Address - Phone:646-421-5353
Mailing Address - Fax:
Practice Address - Street 1:199 GELSTON AVE
Practice Address - Street 2:APT C6
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7057
Practice Address - Country:US
Practice Address - Phone:646-421-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302385164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse