Provider Demographics
NPI:1194332072
Name:LAWARRE, AMEENA MARIA (IP)
Entity type:Individual
Prefix:MS
First Name:AMEENA
Middle Name:MARIA
Last Name:LAWARRE
Suffix:
Gender:F
Credentials:IP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 MILFORD AVE APT 15C
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-2509
Mailing Address - Country:US
Mailing Address - Phone:937-309-5328
Mailing Address - Fax:
Practice Address - Street 1:27809 ZOOK RD
Practice Address - Street 2:
Practice Address - City:RICHWOOD
Practice Address - State:OH
Practice Address - Zip Code:43344-8925
Practice Address - Country:US
Practice Address - Phone:740-943-3766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
OH8003159376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker