Provider Demographics
NPI:1326071226
Name:LAWSON, THERESA GUNTER (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:GUNTER
Last Name:LAWSON
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 FOREST GLENN CT
Mailing Address - Street 2:
Mailing Address - City:PELZER
Mailing Address - State:SC
Mailing Address - Zip Code:29669-8960
Mailing Address - Country:US
Mailing Address - Phone:864-341-1152
Mailing Address - Fax:
Practice Address - Street 1:104 MAXWELL AVE STE 235
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-2641
Practice Address - Country:US
Practice Address - Phone:864-990-5074
Practice Address - Fax:833-405-1939
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN2685363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0956Medicaid
SCQ61928Medicare UPIN
SCAA12131124Medicare ID - Type Unspecified