Healthcare Provider Details

I. General information

NPI: 1831855980
Provider Name (Legal Business Name): ARMESHIA BRENAE LAWRENCE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. ARMESHIA BRENAE JOHNSON

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4292 GRAY HWY
GRAY GA
31032-5900
US

IV. Provider business mailing address

PO BOX 371
WRIGHTSVILLE GA
31096-0371
US

V. Phone/Fax

Practice location:
  • Phone: 478-864-3448
  • Fax: 478-864-1288
Mailing address:
  • Phone: 478-864-3448
  • Fax: 478-864-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN307396
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: