Healthcare Provider Details

I. General information

NPI: 1720141401
Provider Name (Legal Business Name): MARGARET JANE LAWSON F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 WEEOT WAY
ARCATA CA
95521-4734
US

IV. Provider business mailing address

5440 ISHI PISHI
SOMES BAR CA
95568
US

V. Phone/Fax

Practice location:
  • Phone: 707-825-5000
  • Fax:
Mailing address:
  • Phone: 530-469-3464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9923
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: