Provider Demographics
NPI:1760884407
Name:LAWRENCE, JANCIE WEBB (NP-C)
Entity type:Individual
Prefix:MRS
First Name:JANCIE
Middle Name:WEBB
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211639
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-3639
Mailing Address - Country:US
Mailing Address - Phone:888-897-1887
Mailing Address - Fax:857-343-8192
Practice Address - Street 1:260 ARSENAL PL
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-3171
Practice Address - Country:US
Practice Address - Phone:888-897-1887
Practice Address - Fax:857-343-8192
Is Sole Proprietor?:No
Enumeration Date:2014-09-25
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007229363L00000X
TX1006450363L00000X
MARN2364574363L00000X
IL209025375363L00000X
CA95017062363L00000X
NY346865363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner