Provider Demographics
NPI:1780907634
Name:LAWSON, SERENA LYNETTE (LPN)
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:LYNETTE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 FLEMMING RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-3516
Mailing Address - Country:US
Mailing Address - Phone:513-267-0619
Mailing Address - Fax:
Practice Address - Street 1:2600 FLEMMING RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-3516
Practice Address - Country:US
Practice Address - Phone:513-267-0619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-07
Last Update Date:2010-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 127332164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse