Healthcare Provider Details

I. General information

NPI: 1104467877
Provider Name (Legal Business Name): CLAUDIA A PORTER-LAWRENCE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CLAUDIA A PORTER APRN

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 06/16/2024
Certification Date: 06/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 NW FEDERAL HWY STE 215
STUART FL
34994-1019
US

IV. Provider business mailing address

850 NW FEDERAL HWY STE 215
STUART FL
34994-1019
US

V. Phone/Fax

Practice location:
  • Phone: 772-444-8879
  • Fax: 772-492-4362
Mailing address:
  • Phone: 772-444-8879
  • Fax: 772-492-4362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11004398
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: