Provider Demographics
NPI:1538949375
Name:LAWRENCE, SHARON DEONDRA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:DEONDRA
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 ERIE ST S
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-7976
Mailing Address - Country:US
Mailing Address - Phone:330-833-3135
Mailing Address - Fax:330-833-6686
Practice Address - Street 1:3000 ERIE ST S
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-7976
Practice Address - Country:US
Practice Address - Phone:330-833-3135
Practice Address - Fax:330-833-6686
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0034825363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health