Healthcare Provider Details

I. General information

NPI: 1003770496
Provider Name (Legal Business Name): LILLIAN M LAWRENCE-BRIGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LILLY MARIE LAWRENCE-BRIGGS NP, RN

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3883 AIRWAY DR STE 300
SANTA ROSA CA
95403-1671
US

IV. Provider business mailing address

3854 WILLOWVIEW CT
SANTA ROSA CA
95403-1683
US

V. Phone/Fax

Practice location:
  • Phone: 707-573-5426
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95192710
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95040382
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95040382
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: