Individual
LLOREN AVERI LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
508 N MAIN ST STE A, HINESVILLE, GA 31313-2570
(912) 785-2100
(912) 368-3868
Mailing address
508 N MAIN ST STE A, HINESVILLE, GA 31313-2570
(912) 785-2100
(912) 368-3868
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13528
GA
363A00000X
Physician Assistant
Primary
—
GA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13528
GEORGIA COMPOSITE MEDICAL BOARD
GA
Enumeration date
06/10/2021
Last updated
08/06/2026
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