Provider Demographics
NPI:1982325445
Name:LAWRENCE, BRIAN PAUL (RN)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:PAUL
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:BRIAN
Other - Middle Name:PAUL
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:251 BETHANY HOME DR
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-7566
Mailing Address - Country:US
Mailing Address - Phone:123-931-8801
Mailing Address - Fax:
Practice Address - Street 1:251 BETHANY HOME DR
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-7566
Practice Address - Country:US
Practice Address - Phone:123-931-8801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9217509163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health