Individual
MEGAN LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6375 US HIGHWAY 6 STE B, PORTAGE, IN 46368-5218
(219) 762-0400
Mailing address
6375 US HIGHWAY 6, STE B, PORTAGE, IN 46368-5218
(847) 605-0030
(847) 637-0737
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209016594
IL
363LF0000X
Family Nurse Practitioner
Primary
71008287A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300018842
—
IN
01
—
F400433560
MEDICARE PIN
IL
Enumeration date
09/20/2017
Last updated
11/08/2019
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