Healthcare Provider Details

I. General information

NPI: 1083548184
Provider Name (Legal Business Name): ANDREA LYNN LAWRENCE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. ANDREA LYNN FIERRO

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 DON PASQUAL RD NW
LOS LUNAS NM
87031-8841
US

IV. Provider business mailing address

PO BOX 27561
ALBUQUERQUE NM
87125-7561
US

V. Phone/Fax

Practice location:
  • Phone: 505-865-4618
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number65914
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: