MEDICARE: KATHY J. LAWRENCE ARNP

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	363LA2200X	Adult Health Nurse Practitioner	ARNP9342717	FL

General Provider Information

NPI Number	:	1861978116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY J. LAWRENCE ARNP

Provider Business Mailing Address
First Line	:	3115 CITRUS TOWER BLVD STE A
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-6880
Country	:	US
Telephone Number	:	352-394-4237
Fax Number	:	352-394-6097

Provider Business Practice Location Address
First Line	:	3115 CITRUS TOWER BLVD STE A
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-6880
Country	:	US
Telephone Number	:	352-394-4237
Fax Number	:	352-394-6097

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

Provider Enumeration Date	:	07/18/2018
Last Update Date	:	10/13/2018

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