Provider Demographics
NPI:1194292268
Name:LAWRENCE, CLARISSA M (DNP, APNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:CLARISSA
Middle Name:M
Last Name:LAWRENCE
Suffix:
Gender:
Credentials:DNP, APNP, FNP-BC
Other - Prefix:DR
Other - First Name:CLARISSA
Other - Middle Name:MARIE
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, APNP, FNP-BC
Mailing Address - Street 1:7929 N 76TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-3947
Mailing Address - Country:US
Mailing Address - Phone:414-554-9774
Mailing Address - Fax:414-979-0325
Practice Address - Street 1:7929 N 76TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-3947
Practice Address - Country:US
Practice Address - Phone:414-554-9774
Practice Address - Fax:414-979-0325
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8814-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily