Provider Demographics
NPI:1083129035
Name:LAWSON, LUSHAWNA ELIZABETH (PHARMD, MPA)
Entity Type:Individual
Prefix:
First Name:LUSHAWNA
Middle Name:ELIZABETH
Last Name:LAWSON
Suffix:
Gender:F
Credentials:PHARMD, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 DAN JONES ROAD
Mailing Address - Street 2:MEIJER, INC., STORE #256, PHARMACY DEPT.
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168
Mailing Address - Country:US
Mailing Address - Phone:317-204-1310
Mailing Address - Fax:317-204-1365
Practice Address - Street 1:400 N DAN JONES RD # 256
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-1802
Practice Address - Country:US
Practice Address - Phone:317-204-1310
Practice Address - Fax:317-204-1365
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26021367A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist