Provider Demographics
NPI:1174352488
Name:LAWRENCE, MERRIJEANNE (RN)
Entity type:Individual
Prefix:
First Name:MERRIJEANNE
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 E MCKELLIPS RD APT 2012
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-3076
Mailing Address - Country:US
Mailing Address - Phone:414-708-8719
Mailing Address - Fax:
Practice Address - Street 1:2250 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2252
Practice Address - Country:US
Practice Address - Phone:480-459-5048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI166408-30163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool