Basic Information
Provider Information
NPI: 1124069281
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAWRENCE
FirstName: ROSLYN
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 246 PLEASANT STREET MEMORIAL BUILDING, WEST, GROUND FLO
Address2:  
City: CONCORD
State: NH
PostalCode: 033012588
CountryCode: US
TelephoneNumber: 6032249661
FaxNumber: 6032287051
Practice Location
Address1: 246 PLEASANT STREET MEMORIAL BUILDING, WEST, GROUND FLO
Address2:  
City: CONCORD
State: NH
PostalCode: 033012588
CountryCode: US
TelephoneNumber: 6032249661
FaxNumber: 6032287051
Other Information
ProviderEnumerationDate: 06/09/2006
LastUpdateDate: 07/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X026473-23-12NHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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