Provider Demographics
NPI:1154414290
Name:LAWRENCE, SHAWN S (MD)
Entity type:Individual
Prefix:MRS
First Name:SHAWN
Middle Name:S
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:805 SOUTH F STREET
Mailing Address - Street 2:PO BOX 647
Mailing Address - City:BROKEN BOW
Mailing Address - State:NE
Mailing Address - Zip Code:68822-0647
Mailing Address - Country:US
Mailing Address - Phone:308-872-6456
Mailing Address - Fax:308-872-6040
Practice Address - Street 1:805 SOUTH F STREET
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:NE
Practice Address - Zip Code:68822-0647
Practice Address - Country:US
Practice Address - Phone:308-872-6456
Practice Address - Fax:308-872-6040
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2011-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE19116207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEF64274Medicare UPIN