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General NPI Number Information
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NPI Number | 1255952149
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Entity Type | Organization
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Legal Business Name | CLARISSA MARIE LAWRENCE
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Dates
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Enumeration Date | 05/01/2020
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 7929 N 76TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53223-3947
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Country | US
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Telephone | 414-554-9774
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Fax | 414-979-0325
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Provider Business Mailing Address
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Address Line | 7929 N 76TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53223-3947
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Country | US
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Telephone | 414-554-9774
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Fax | 414-979-0325
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Authorized Official
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Title or Position | OWNER/FAMILY NURSE PRACTITIONER
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Name | DR. CLARISSA M LAWRENCE
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Credential | DNP, APNP, FNP-BC
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Telephone | 414-554-9774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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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 |
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License Number State |
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