Provider Demographics
NPI:1851473516
Name:LAWSON, KATHRYN R (RPH)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:R
Last Name:LAWSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46280-1283
Mailing Address - Country:US
Mailing Address - Phone:317-571-0621
Mailing Address - Fax:
Practice Address - Street 1:1913 VALLEY DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-1283
Practice Address - Country:US
Practice Address - Phone:317-571-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018958A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26018958AOtherPHARMACIST