Provider Demographics
NPI:1962826115
Name:LAWRENCE, PAULA R (CNM)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:R
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 GREGORY RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON FLATS
Mailing Address - State:NY
Mailing Address - Zip Code:13315-3223
Mailing Address - Country:US
Mailing Address - Phone:607-267-2731
Mailing Address - Fax:
Practice Address - Street 1:1 ATWELL RD
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1301
Practice Address - Country:US
Practice Address - Phone:607-547-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-08
Last Update Date:2014-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001592367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife