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General NPI Number Information
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NPI Number | 1073066437
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Entity Type | Individual
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Provider Name | JENNIFER MARIE LAWRENCE C.N.P.
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Gender | Female
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 442 N IL ROUTE 31
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City | CRYSTAL LAKE
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State | IL
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Zip | 60012-3709
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Country | US
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Telephone | 224-238-3211
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Fax | 224-535-8215
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Provider Business Mailing Address
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Address Line | PO BOX 3877
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City | JOLIET
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State | IL
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Zip | 60434-3877
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Country | US
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Telephone | 815-714-7171
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Fax | 815-435-5080
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041.368523
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.014655
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209014655
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License Number State | IL
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