Healthcare Provider Details

I. General information

NPI: 1114020799
Provider Name (Legal Business Name): DEBBIE LEE LAWLOR RN MSN ANPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 NEW JERSEY AVENUE CREST MEDICAL ASSOCIATES
WILDWOOD NJ
08260
US

IV. Provider business mailing address

153 W TAYLOR AVE UNIT 6F
WILDWOOD NJ
08260
US

V. Phone/Fax

Practice location:
  • Phone: 609-523-1331
  • Fax:
Mailing address:
  • Phone: 609-458-2144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00105900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: