Laura L Lawrence, P.A.
Physician Assistant, Medical in Boise, ID. Individual provider (NPI-1).
NPI number1154528792
StatusActive
Last updated in NPPESDec 7, 2023
Details
- NPI
- 1154528792
- Entity type
- Individual (NPI-1)
- Name
- Laura L Lawrence
- Credential
- P.A.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 28, 2007
- Certification date
- Aug 23, 2023
- Last updated
- Dec 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA05010 | TX | Yes |
Practice location
444 W Fort St Fl 2Boise, ID 83702-4535
Phone 208-422-1018
Mailing address
444 W Fort St Fl 2Boise, ID 83702-4535
Phone 208-422-1018
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