Provider Demographics
NPI:1114542701
Name:LAWSON, SHEREASE NICOLE (PCD,PCPD)
Entity Type:Individual
Prefix:
First Name:SHEREASE
Middle Name:NICOLE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:PCD,PCPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 MARTIN FARMS DR
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-8429
Mailing Address - Country:US
Mailing Address - Phone:678-687-7864
Mailing Address - Fax:
Practice Address - Street 1:4905 MARTIN FARMS DR
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-8429
Practice Address - Country:US
Practice Address - Phone:678-687-7864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty