Individual
JACQUELINE EVETT LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4200 REGENT ST STE 200, COLUMBUS, OH 43219-6229
(877) 870-1775
(614) 968-8840
Mailing address
903 69TH CT, MERIDIAN, MS 39305-8100
(304) 516-3930
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
906899
MS
363L00000X
Nurse Practitioner
95032706
CA
363L00000X
Nurse Practitioner
F05230722
VA
363LF0000X
Family Nurse Practitioner
Primary
0024187405
VA
Other
Enumeration date
05/31/2023
Last updated
01/02/2025
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