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General NPI Number Information
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NPI Number | 1235591363
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Entity Type | Individual
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Provider Name | JESSICA B LAWRENCE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 03/28/2016
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 289 GREAT RD STE G1
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City | ACTON
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State | MA
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Zip | 01720-4766
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Country | US
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Telephone | 978-679-1200
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Fax | 978-486-4037
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Provider Business Mailing Address
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Address Line | 100 TER HEUN DR
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City | FALMOUTH
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State | MA
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Zip | 02540-2503
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Country | US
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Telephone | 508-495-8517
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Fax | 508-477-7028
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 284923
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License Number State | MA
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