Individual
ADDIE LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
416 BELMONT ST, WORCESTER, MA 01604-1086
(508) 756-1808
(508) 756-1808
Mailing address
416 BELMONT ST, WORCESTER, MA 01604-1086
(508) 756-1808
(508) 756-1808
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
264754
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0710211
—
MA
05
—
9771476
—
MA
01
—
M20928
GROUP MEDICARE
MA
Enumeration date
12/15/2006
Last updated
11/21/2013
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