Provider Demographics
NPI:1700201035
Name:LAWSON, TAMI (APRN)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TAMI
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:8105 NW EXPRESSWAY, SUITE A
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-6004
Mailing Address - Country:US
Mailing Address - Phone:405-602-3500
Mailing Address - Fax:405-602-3550
Practice Address - Street 1:8105 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-6004
Practice Address - Country:US
Practice Address - Phone:405-602-3500
Practice Address - Fax:405-602-3550
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK99221363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200525110AMedicaid