Provider Demographics
NPI:1780166108
Name:MCLAWRENCE, JANELL ANTHONY (RN)
Entity type:Individual
Prefix:MR
First Name:JANELL
Middle Name:ANTHONY
Last Name:MCLAWRENCE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 W MAIN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CLIFTON SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14432-1053
Mailing Address - Country:US
Mailing Address - Phone:646-469-0207
Mailing Address - Fax:
Practice Address - Street 1:44 W MAIN ST APT 2
Practice Address - Street 2:
Practice Address - City:CLIFTON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14432-1053
Practice Address - Country:US
Practice Address - Phone:646-469-0207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY755468163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse