Provider Demographics
NPI:1134694342
Name:LAWSON, CAROL J (RN CDE)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:J
Last Name:LAWSON
Suffix:
Gender:F
Credentials:RN CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 W STATE ROUTE 89A STE 102
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-3763
Mailing Address - Country:US
Mailing Address - Phone:928-639-6346
Mailing Address - Fax:928-639-6623
Practice Address - Street 1:294 W STATE ROUTE 89A STE 102
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-3763
Practice Address - Country:US
Practice Address - Phone:928-639-6346
Practice Address - Fax:928-639-6623
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN138595163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator