Provider Demographics
NPI:1649141524
Name:LAWRENCE, JULIE (RN)
Entity type:Individual
Prefix:
First Name:JULIE
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 1:617 GREEN POND RD
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-7613
Mailing Address - Country:US
Mailing Address - Phone:803-579-5260
Mailing Address - Fax:
Practice Address - Street 1:617 GREEN POND RD
Practice Address - Street 2:
Practice Address - City:CLOVER
Practice Address - State:SC
Practice Address - Zip Code:29710-7613
Practice Address - Country:US
Practice Address - Phone:803-579-5260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC252868163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice