Provider Demographics
NPI:1689348419
Name:LAWSON, AMANDA K (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:K
Last Name:LAWSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 RENEA DR
Mailing Address - Street 2:
Mailing Address - City:GREENBRIER
Mailing Address - State:AR
Mailing Address - Zip Code:72058-9615
Mailing Address - Country:US
Mailing Address - Phone:501-470-5075
Mailing Address - Fax:
Practice Address - Street 1:75 S BROADVIEW ST
Practice Address - Street 2:
Practice Address - City:GREENBRIER
Practice Address - State:AR
Practice Address - Zip Code:72058-9231
Practice Address - Country:US
Practice Address - Phone:501-287-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15879183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist