Provider Demographics
NPI:1295894046
Name:LAWRENCE, CINDY (LPN)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10574 TAMME RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45697-9618
Mailing Address - Country:US
Mailing Address - Phone:937-695-0066
Mailing Address - Fax:
Practice Address - Street 1:10574 TAMME RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45697-9618
Practice Address - Country:US
Practice Address - Phone:937-695-0066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 113899164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH105774532399Medicaid