Healthcare Provider Details

I. General information

NPI: 1508560251
Provider Name (Legal Business Name): ANGELIQUE RAFFINEE LAWSON DNP, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 BROAD ST
AUGUSTA GA
30901-1214
US

IV. Provider business mailing address

2241 SUNNY DAY DR
HEPHZIBAH GA
30815-7210
US

V. Phone/Fax

Practice location:
  • Phone: 802-239-6065
  • Fax: 855-780-0882
Mailing address:
  • Phone: 802-239-6065
  • Fax: 855-780-0882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP244589
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: