Provider Demographics
NPI:1336685171
Name:LAWSETH, NADIA
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:LAWSETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10835 N 25TH AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-3458
Mailing Address - Country:US
Mailing Address - Phone:620-246-2584
Mailing Address - Fax:
Practice Address - Street 1:10835 N 25TH AVE STE 240
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-3458
Practice Address - Country:US
Practice Address - Phone:620-246-2584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9733363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner