=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154043057
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MADISON ELIZABETH LAWRENCE PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2022
-----------------------------------------------------
Last Update Date | 09/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 470 EISENHOWER DR
-----------------------------------------------------
City | HANOVER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17331-5248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-633-0031
-----------------------------------------------------
Fax | 717-630-1085
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1861 POWDER MILL ROAD ATTN MEDICAL STAFF OFFICE
-----------------------------------------------------
City | YORK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17402-4723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-718-2041
-----------------------------------------------------
Fax | 717-747-2102
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | OA006468
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | MA064067
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------