Provider Demographics
NPI:1013994003
Name:LAWRENCE, AARON S (NP)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:S
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 PRINTERS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3190
Mailing Address - Country:US
Mailing Address - Phone:719-630-6440
Mailing Address - Fax:719-228-6609
Practice Address - Street 1:2502 E PIKES PEAK AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-6033
Practice Address - Country:US
Practice Address - Phone:719-632-5700
Practice Address - Fax:719-228-6603
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO109822363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09908757Medicaid
CO09908757Medicaid
CO503888Medicare ID - Type Unspecified