Provider Demographics
NPI:1932463403
Name:KILLION-LAWSON, GAIL RENEE (FNP-C)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:RENEE
Last Name:KILLION-LAWSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:651 N. DENTON TAP ROAD #100
Mailing Address - Street 2:#100
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019
Mailing Address - Country:US
Mailing Address - Phone:972-899-3722
Mailing Address - Fax:972-899-0442
Practice Address - Street 1:651 N. DENTON TAP ROAD
Practice Address - Street 2:#100
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019
Practice Address - Country:US
Practice Address - Phone:972-899-3722
Practice Address - Fax:972-899-0442
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2016-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX650975207Q00000X
TXAP121829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX265809YMZXMedicare PIN