Provider Demographics
NPI:1750027850
Name:LAWRENCE, DWAN PATRINA
Entity Type:Individual
Prefix:
First Name:DWAN
Middle Name:PATRINA
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 1:570 WALDON AVE
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-3635
Mailing Address - Country:US
Mailing Address - Phone:863-229-6183
Mailing Address - Fax:
Practice Address - Street 1:570 WALDON AVE
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-3635
Practice Address - Country:US
Practice Address - Phone:863-229-6183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
No376J00000XNursing Service Related ProvidersHomemaker