Provider Demographics
NPI:1659671691
Name:LAWRENCE, ANN MARLENE
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARLENE
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 NEW LOTS AVE
Mailing Address - Street 2:APT 1C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-6537
Mailing Address - Country:US
Mailing Address - Phone:718-644-6795
Mailing Address - Fax:
Practice Address - Street 1:312 NEW LOTS AVE
Practice Address - Street 2:APT 1C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-6537
Practice Address - Country:US
Practice Address - Phone:718-644-6795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide