Individual
MRS. MARY KATHERINE LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
220 HIGHWAY 12 W, KOSCIUSKO, MS 39090-3208
(662) 290-3150
(662) 290-3160
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-3255
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
672602
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03338302
—
MS
Enumeration date
04/07/2006
Last updated
01/27/2021
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