Individual
KEISHONTA LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 VAN GORDER ST, BUFFALO, NY 14214-2818
(716) 578-6309
Mailing address
20 VAN GORDER ST, BUFFALO, NY 14214-2818
(716) 578-6309
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
306926
NY
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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