MEDICARE: JAZZLYN LAWSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	923299	TX

General Provider Information

NPI Number	:	1538794227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAZZLYN LAWSON

Provider Business Mailing Address
First Line	:	507 E PIRATE ST
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75604-2429
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	507 E PIRATE ST
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75604-2429
Country	:	US
Telephone Number	:	903-736-7848
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2020
Last Update Date	:	03/03/2020

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Directions to “ JAZZLYN LAWSON ” Practice Location

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