Provider Demographics
NPI:1508137332
Name:LAWSON, JILL HAMILTON (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:HAMILTON
Last Name:LAWSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 20TH ST STE 606
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1863
Mailing Address - Country:US
Mailing Address - Phone:865-546-8040
Mailing Address - Fax:865-541-2288
Practice Address - Street 1:501 20TH ST STE 606
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1863
Practice Address - Country:US
Practice Address - Phone:865-546-8040
Practice Address - Fax:865-541-2288
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000087915163W00000X
TN16700367500000X
NC89833367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNRN0000087195OtherRN
TN16700OtherAPN
TN1529070Medicaid
NC89833OtherCRNA
12395899OtherCAQH
103I432182Medicare PIN