Provider Demographics
NPI:1528047677
Name:LAWRENCE, PATRICIA A (MSN, FNP, PMHNP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MSN, FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4175 N HIGHWAY 101 UNIT B4
Mailing Address - Street 2:
Mailing Address - City:DEPOE BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97341-9729
Mailing Address - Country:US
Mailing Address - Phone:719-671-0925
Mailing Address - Fax:
Practice Address - Street 1:1 SERENITY LN
Practice Address - Street 2:
Practice Address - City:COBURG
Practice Address - State:OR
Practice Address - Zip Code:97408-9350
Practice Address - Country:US
Practice Address - Phone:719-671-0925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0005062-NP363L00000X, 363LF0000X, 363LP0808X
CORXN.0004043-NP363L00000X, 363LF0000X, 363LP0808X
AZAP0889363LF0000X
OR201050027NP363LF0000X
AZRN063755163W00000X
OR087006925RN163W00000X
CORN.0088358163W00000X
OR201050043NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse