Individual
JESSICA LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5114 N GLEN PARK PLACE RD, PEORIA, IL 61614-4686
(309) 655-2431
Mailing address
5114 N GLEN PARK PLACE RD, PEORIA, IL 61614-4686
(309) 655-2431
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.028422
IL
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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