Provider Demographics
NPI:1396378501
Name:LAWSON, AMANDA RENEE (FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:RENEE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1759 SALT GUM RD
Mailing Address - Street 2:
Mailing Address - City:SCALF
Mailing Address - State:KY
Mailing Address - Zip Code:40982-6510
Mailing Address - Country:US
Mailing Address - Phone:606-627-1743
Mailing Address - Fax:
Practice Address - Street 1:215 TREUHAFT BLVD STE 3B
Practice Address - Street 2:
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906-7361
Practice Address - Country:US
Practice Address - Phone:606-545-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-16
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014277363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily