Provider Demographics
NPI:1861473084
Name:LAWSON, BARBARA (RN MSN NPC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:RN MSN NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28963 LITTLE MACK AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:ST CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-3015
Mailing Address - Country:US
Mailing Address - Phone:586-447-0700
Mailing Address - Fax:586-498-0707
Practice Address - Street 1:28963 LITTLE MACK AVE
Practice Address - Street 2:STE 101
Practice Address - City:ST CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-3015
Practice Address - Country:US
Practice Address - Phone:586-447-0700
Practice Address - Fax:586-498-0707
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704161454363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI441209310Medicaid
ON59210Medicare ID - Type Unspecified
MI441209310Medicaid