MEDICARE: DEBBIE LEE LAWLOR RN MSN ANPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	26NJ00105900	NJ

General Provider Information

NPI Number	:	1114020799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBBIE LEE LAWLOR RN MSN ANPC

Provider Business Mailing Address
First Line	:	153 W TAYLOR AVE
Second Line	:	UNIT 6F
City	:	WILDWOOD
State	:	NJ
Zip	:	08260
Country	:	US
Telephone Number	:	609-458-2144
Fax Number	:

Provider Business Practice Location Address
First Line	:	6410 NEW JERSEY AVENUE
Second Line	:	CREST MEDICAL ASSOCIATES
City	:	WILDWOOD
State	:	NJ
Zip	:	08260
Country	:	US
Telephone Number	:	609-523-1331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	07/08/2007

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