Healthcare Provider Details

I. General information

NPI: 1295972859
Provider Name (Legal Business Name): MELISSA M LAWSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2009
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 KIMBALL AVE STE 101
WATERLOO IA
50702-5047
US

IV. Provider business mailing address

2055 KIMBALL AVE STE 101
WATERLOO IA
50702-5047
US

V. Phone/Fax

Practice location:
  • Phone: 319-272-2112
  • Fax: 319-272-2107
Mailing address:
  • Phone: 319-272-2112
  • Fax: 319-272-2107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5004272
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: