Healthcare Provider Details

I. General information

NPI: 1306192968
Provider Name (Legal Business Name): RACHEL ANNE LAWRENCE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W MAIN ST STE 330
TROY OH
45373-3384
US

IV. Provider business mailing address

106 N MAIN ST
NEW CARLISLE OH
45344-1835
US

V. Phone/Fax

Practice location:
  • Phone: 937-980-7400
  • Fax: 937-980-7409
Mailing address:
  • Phone: 937-667-1122
  • Fax: 419-549-5671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.13695-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: