Provider Demographics
NPI:1508541145
Name:LAWRENCE, MARTHA MICHELLE (LPN)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:MICHELLE
Last Name:LAWRENCE
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 1:115 EASTPARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7548
Mailing Address - Country:US
Mailing Address - Phone:615-383-6272
Mailing Address - Fax:
Practice Address - Street 1:115 EASTPARK DR STE 200
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7548
Practice Address - Country:US
Practice Address - Phone:615-383-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0038512164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse