Provider Demographics
NPI:1780199927
Name:LAWSON, SAMANTHA (CNM, WHNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:CNM, WHNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2624 SOUTHERN BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7433
Mailing Address - Country:US
Mailing Address - Phone:757-453-1256
Mailing Address - Fax:319-359-3813
Practice Address - Street 1:2624 SOUTHERN BLVD STE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7433
Practice Address - Country:US
Practice Address - Phone:757-453-1256
Practice Address - Fax:319-359-3813
Is Sole Proprietor?:No
Enumeration Date:2017-12-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177392363LW0102X, 367A00000X, 363LP0808X
COAPN.0997973-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife