Provider Demographics
NPI:1851613228
Name:LAWSON, TERRY (APRN)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:LAWSON
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 LAWSON LN
Mailing Address - Street 2:
Mailing Address - City:WHITLEY CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42653-4215
Mailing Address - Country:US
Mailing Address - Phone:606-376-5750
Mailing Address - Fax:606-376-7216
Practice Address - Street 1:71 MEDICAL LN
Practice Address - Street 2:
Practice Address - City:WHITLEY CITY
Practice Address - State:KY
Practice Address - Zip Code:42653-4216
Practice Address - Country:US
Practice Address - Phone:606-376-7212
Practice Address - Fax:606-376-7216
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6373S364S00000X
KY3006373363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP39421Medicare UPIN