Provider Demographics
NPI:1679525620
Name:STRONG, LAWRENCE ANTHONY (CRNA)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:ANTHONY
Last Name:STRONG
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:1755 KIRBY PKWY
Mailing Address - Street 2:#330
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-8300
Mailing Address - Country:US
Mailing Address - Phone:901-725-5846
Mailing Address - Fax:901-726-4827
Practice Address - Street 1:1755 KIRBY PKWY
Practice Address - Street 2:#330
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-8300
Practice Address - Country:US
Practice Address - Phone:901-725-5846
Practice Address - Fax:901-726-4827
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2010-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN 11204367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3902350Medicaid
TN3902350Medicaid