Provider Demographics
NPI:1437768165
Name:LAWRENCE, SUNNY JEAN (RN)
Entity Type:Individual
Prefix:
First Name:SUNNY
Middle Name:JEAN
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 WEST DD HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:MO
Mailing Address - Zip Code:64759-6475
Mailing Address - Country:US
Mailing Address - Phone:417-850-5656
Mailing Address - Fax:
Practice Address - Street 1:379 WEST DD HIGHWAY
Practice Address - Street 2:
Practice Address - City:LAMAR
Practice Address - State:MO
Practice Address - Zip Code:64759-6475
Practice Address - Country:US
Practice Address - Phone:417-850-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015016745163W00000X
MO2021022493363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse