Provider Demographics
NPI:1417979535
Name:LAWRENCE, YOLANDA G (MD)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:G
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 S. CHESTNUT STREET
Mailing Address - Street 2:WALTER L. AUMENT FAMILY HEALTH CENTER
Mailing Address - City:QUARRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17566-1344
Mailing Address - Country:US
Mailing Address - Phone:717-786-7383
Mailing Address - Fax:717-786-8635
Practice Address - Street 1:317 S. CHESTNUT STREET
Practice Address - Street 2:WALTER L. AUMENT FAMILY HEALTH CENTER
Practice Address - City:QUARRYVILLE
Practice Address - State:PA
Practice Address - Zip Code:17566-1344
Practice Address - Country:US
Practice Address - Phone:717-786-7383
Practice Address - Fax:717-786-8635
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT042-0009417207Q00000X
PAMD446384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30203343Medicaid
VTOVN1566Medicaid
VTVN1566Medicare Oscar/Certification
NH30203343Medicaid