Provider Demographics
NPI:1326678996
Name:LAWSON, LAURA RIVERA (CRNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:RIVERA
Last Name:LAWSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 THIRD AVE
Mailing Address - Street 2:
Mailing Address - City:CROYDON
Mailing Address - State:PA
Mailing Address - Zip Code:19021-6647
Mailing Address - Country:US
Mailing Address - Phone:302-981-4542
Mailing Address - Fax:610-961-5442
Practice Address - Street 1:517 THIRD AVE
Practice Address - Street 2:
Practice Address - City:CROYDON
Practice Address - State:PA
Practice Address - Zip Code:19021-6647
Practice Address - Country:US
Practice Address - Phone:302-981-4542
Practice Address - Fax:610-961-5442
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN647075163W00000X
PASP021620363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse