Individual
NICOLE TERESA LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
23 MACK BAYOU LOOP STE 100, SANTA ROSA BEACH, FL 32459-2606
(850) 416-1575
Mailing address
PO BOX 2699, PENSACOLA, FL 32513-2699
(850) 475-4686
(850) 475-4619
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
ME111073
FL
282NC2000X
Children's Hospital
—
—
Other
Enumeration date
07/26/2008
Last updated
03/17/2018
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