| NPI | 1174514459 |
|---|---|
| Former Name | STACEY A. LAWRENCE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: OH APRN.CNP.07722) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH NP07722) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2022-03-08 |