Provider Demographics
NPI:1457973588
Name:LAWTON, RALPHEANA DENEE
Entity Type:Individual
Prefix:
First Name:RALPHEANA
Middle Name:DENEE
Last Name:LAWTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 N MILITARY HWY # 253
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2228
Mailing Address - Country:US
Mailing Address - Phone:757-807-9754
Mailing Address - Fax:877-683-9562
Practice Address - Street 1:2317 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704
Practice Address - Country:US
Practice Address - Phone:757-807-9754
Practice Address - Fax:877-683-9562
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care