Provider Demographics
NPI:1609450782
Name:LAWSON, RYAN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66691 E 280 RD
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-6279
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 MAIN ST
Practice Address - Street 2:
Practice Address - City:NOEL
Practice Address - State:MO
Practice Address - Zip Code:64854-9124
Practice Address - Country:US
Practice Address - Phone:417-475-6151
Practice Address - Fax:417-475-6559
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK201929363LF0000X
MO2021025113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily