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1104121102
LA TANYA LAWRENCE
SAINT LOUIS, MO
NPI
1104121102
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MO 2019005430)
Enumeration Date
2011-01-21
Last Update Date
2023-03-28
Business Address
LA TANYA LAWRENCE AS
5471 DR MARTIN LUTHER KING DR
SAINT LOUIS, MO 63112-4265
Phone number: 314-367-5820
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Mailing Address
LA TANYA LAWRENCE AS
4433 WOODSON RD STE 220
SAINT LOUIS, MO 63134-3713
Phone number: 314-265-7131
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