Provider Demographics
NPI:1376927137
Name:LAWSON, NICOLE
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:
Last Name:LAWSON
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 1:1136 MOUNT RUSHMORE WAY # A
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-5437
Mailing Address - Country:US
Mailing Address - Phone:859-227-4404
Mailing Address - Fax:
Practice Address - Street 1:1136 MOUNT RUSHMORE WAY # A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-5437
Practice Address - Country:US
Practice Address - Phone:859-227-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-11
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator