Active NPI
Keanan Lawrence, AGACNP-BC
- Acute Care Nurse Practitioner
- Seminole, FL
National Provider Identifier
1073213583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 11025100
- Practice address
- 11725 Oxford St
Seminole, FL 33772-6513 - Phone
- (727) 225-1366
- NPI assigned
- Mar 6, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 11025100 | FL | Primary |
Addresses
Primary practice location
11725 Oxford St
Seminole, FL 33772-6513
Mailing address
11725 Oxford St
Seminole, FL 33772-6513
Phone (727) 225-1366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11025100 | FL | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678838400000",
"number": "1073213583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11725 OXFORD ST",
"city": "SEMINOLE",
"state": "FL",
"postal_code": "337726513",
"telephone_number": "727-225-1366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11725 OXFORD ST",
"city": "SEMINOLE",
"state": "FL",
"postal_code": "337726513",
"telephone_number": "727-225-1366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWRENCE",
"first_name": "KEANAN",
"credential": "AGACNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-06",
"last_updated": "2023-03-15",
"certification_date": "2023-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "FL",
"license": "11025100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seminole, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.