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NPI Code Detail

MEDICARE: MS. CYNTHIA JUNE LAWRENCE P.A.

MEDICARE: MS. CYNTHIA JUNE LAWRENCE P.A.
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
1363AM0700XMedical Physician Assistant110CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578528931
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CYNTHIA JUNE LAWRENCE P.A.
Provider Business Mailing Address
First Line : 345 MAXWELL AVE
Second Line :
City : BOULDER
State : CO
Zip : 80304-3972
Country : US
Telephone Number : 303-544-5783
Fax Number : 303-441-2388
Provider Business Practice Location Address
First Line : 2995 BASELINE RD
Second Line : SUITE 210
City : BOULDER
State : CO
Zip : 80303-2318
Country : US
Telephone Number : 303-443-2544
Fax Number : 303-443-6476
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 11/15/2013

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