Healthcare Provider Details

I. General information

NPI: 1003250341
Provider Name (Legal Business Name): MICHELEE LAWRENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28166 ARROWHEAD CIR
PUNTA GORDA FL
33982-4807
US

IV. Provider business mailing address

28166 ARROWHEAD CIR
PUNTA GORDA FL
33982-4807
US

V. Phone/Fax

Practice location:
  • Phone: 567-303-4480
  • Fax:
Mailing address:
  • Phone: 567-303-4480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN9627983
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9627983
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN9627983
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: