Provider Demographics
NPI:1871580449
Name:LAWRENCE, SANDRA P (NP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:P
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325E KENNEDY MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4531
Mailing Address - Country:US
Mailing Address - Phone:207-873-5665
Mailing Address - Fax:207-873-5545
Practice Address - Street 1:325E KENNEDY MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4531
Practice Address - Country:US
Practice Address - Phone:207-873-5665
Practice Address - Fax:207-873-5545
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER019881363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME040649OtherANTHEM
MEP00441784OtherRAILROAD MEDICARE
ME270700099Medicaid
MEP55782OtherHARVARD PILGRIM HEALTHCAR
ME270700099Medicaid
MENP376101Medicare PIN