Provider Demographics
NPI:1336591643
Name:LAWSON, KELLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KELLE
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SW LONGVIEW BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2116
Mailing Address - Country:US
Mailing Address - Phone:913-215-5008
Mailing Address - Fax:913-297-1202
Practice Address - Street 1:409 W AUBERRY GRV
Practice Address - Street 2:
Practice Address - City:JAMESPORT
Practice Address - State:MO
Practice Address - Zip Code:64648-7189
Practice Address - Country:US
Practice Address - Phone:660-684-6252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016022495363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily