Individual
TANISHA LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 ELM AVE SE, ROANOKE, VA 24013-2222
(540) 985-8000
Mailing address
558 PETTY AVE, ROANOKE, VA 24019-4730
(540) 580-7687
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
0001304754
VA
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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