Provider Demographics
NPI:1770444713
Name:LAWRENCE, GAIL DEANN (LPN)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:DEANN
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:DEANN
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:519 AMBER LN
Mailing Address - Street 2:
Mailing Address - City:ELK RUN HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50707-1428
Mailing Address - Country:US
Mailing Address - Phone:319-235-1235
Mailing Address - Fax:319-235-1229
Practice Address - Street 1:4000 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-5656
Practice Address - Country:US
Practice Address - Phone:319-235-1230
Practice Address - Fax:319-235-1229
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAP33014164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty