Provider Demographics
NPI:1962523290
Name:LAWRENCE, MARY R (RN CDE)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:R
Last Name:LAWRENCE
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Gender:F
Credentials:RN CDE
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Mailing Address - Street 1:10010 KENNERLY RD
Mailing Address - Street 2:ST. ANTHONY MEDICAL CENTER, DIABETES EDUCATION
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2106
Mailing Address - Country:US
Mailing Address - Phone:314-525-4506
Mailing Address - Fax:314-525-4260
Practice Address - Street 1:10010 KENNERLY RD
Practice Address - Street 2:ST. ANTHONY MEDICAL CENTER, DIABETES EDUCATION
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2106
Practice Address - Country:US
Practice Address - Phone:314-525-4506
Practice Address - Fax:314-525-4260
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO063270163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator