Provider Demographics
NPI:1417422700
Name:LAWSON, CHRISTINA MARGARET (AGACNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARGARET
Last Name:LAWSON
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 FULTON ST W APT 1316
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2678
Mailing Address - Country:US
Mailing Address - Phone:313-614-9127
Mailing Address - Fax:
Practice Address - Street 1:2490 S 11TH ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-2175
Practice Address - Country:US
Practice Address - Phone:269-343-1535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704283199363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care