Provider Demographics
NPI:1962289272
Name:LAWRENCE, ZHANE G
Entity type:Individual
Prefix:
First Name:ZHANE
Middle Name:G
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 CAMERON ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3105
Mailing Address - Country:US
Mailing Address - Phone:682-367-8842
Mailing Address - Fax:
Practice Address - Street 1:2606 CAMERON ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3105
Practice Address - Country:US
Practice Address - Phone:682-367-8842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL882387440Medicaid