Provider Demographics
NPI:1598172652
Name:LAWRENCE, ADAM EMMANUELL (CNA)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:EMMANUELL
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 WINDSOR RD
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-1353
Mailing Address - Country:US
Mailing Address - Phone:207-615-4798
Mailing Address - Fax:
Practice Address - Street 1:510 WINDSOR RD
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:ME
Practice Address - Zip Code:04330-1353
Practice Address - Country:US
Practice Address - Phone:207-615-4798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNA57369376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide