Individual
BEVERLEY LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6549 HUNTINGTON CT, LITHONIA, GA 30058-3040
(424) 332-6459
Mailing address
20687 AMAR RD, WALNUT, CA 91789-5044
(424) 332-6459
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95013161
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
FNP
CA
Enumeration date
12/03/2020
Last updated
12/03/2020
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