Individual
VISHAUN LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5445 AVENUE O, FORT MADISON, IA 52627-9611
(319) 372-6530
Mailing address
5445 AVENUE O, FORT MADISON, IA 52627-9611
(319) 372-6530
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209011761
IL
363L00000X
Nurse Practitioner
Primary
A145966
IA
Other
Enumeration date
10/23/2014
Last updated
12/05/2016
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