Provider Demographics
NPI:1386662476
Name:LAWRENCE, VIRGINIA MARIA (NP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:MARIA
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 OLD SAWMILL LN
Mailing Address - Street 2:
Mailing Address - City:ARUNDEL
Mailing Address - State:ME
Mailing Address - Zip Code:04046-8164
Mailing Address - Country:US
Mailing Address - Phone:207-985-8998
Mailing Address - Fax:207-985-1281
Practice Address - Street 1:9 OLD SAWMILL LN
Practice Address - Street 2:
Practice Address - City:ARUNDEL
Practice Address - State:ME
Practice Address - Zip Code:04046-8164
Practice Address - Country:US
Practice Address - Phone:207-985-8998
Practice Address - Fax:207-985-1281
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81746363L00000X
MERN25906163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432003399Medicaid
MEE400169721Medicare PIN
MENP520901Medicare PIN
ME432003399Medicaid
MENP520903Medicare PIN