Provider Demographics
NPI:1104467877
Name:PORTER-LAWRENCE, CLAUDIA A (APRN)
Entity type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:A
Last Name:PORTER-LAWRENCE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:A
Other - Last Name:PORTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:850 NW FEDERAL HWY STE 215
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-1019
Mailing Address - Country:US
Mailing Address - Phone:772-444-8879
Mailing Address - Fax:772-492-4362
Practice Address - Street 1:850 NW FEDERAL HWY STE 215
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-1019
Practice Address - Country:US
Practice Address - Phone:772-444-8879
Practice Address - Fax:772-492-4362
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2024-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004398363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106145100Medicaid