Provider Demographics
NPI:1235517020
Name:LAWSON NP, PROFESSIONAL CORP
Entity Type:Organization
Organization Name:LAWSON NP, PROFESSIONAL CORP
Other - Org Name:PELICAN FAMILY HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:225-257-1040
Mailing Address - Street 1:PO BOX 973
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-0973
Mailing Address - Country:US
Mailing Address - Phone:225-257-1040
Mailing Address - Fax:225-257-1043
Practice Address - Street 1:6473 HIGHWAY 44
Practice Address - Street 2:STE 103
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-8179
Practice Address - Country:US
Practice Address - Phone:225-257-1040
Practice Address - Fax:225-257-1043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-12
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05619363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty