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NPI Code Detail

MEDICARE: TANISHA LAWRENCE

MEDICARE: TANISHA LAWRENCE
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
1163WM0705XMedical-Surgical Registered Nurse0001304754VA

General Provider Information

NPI Number : 1154258762
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANISHA LAWRENCE
Provider Business Mailing Address
First Line : 558 PETTY AVE
Second Line :
City : ROANOKE
State : VA
Zip : 24019-4730
Country : US
Telephone Number : 540-580-7687
Fax Number :
Provider Business Practice Location Address
First Line : 101 ELM AVE SE
Second Line :
City : ROANOKE
State : VA
Zip : 24013-2222
Country : US
Telephone Number : 540-985-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2026
Last Update Date : 05/06/2026

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Directions to “ TANISHA LAWRENCE ” Practice Location

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