Healthcare Provider Details

I. General information

NPI: 1114452604
Provider Name (Legal Business Name): SARAH LAWSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2017
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SOUTHFIELD DR STE 1240
PLAINFIELD IN
46168-4499
US

IV. Provider business mailing address

111 NEW HAMPSHIRE AVE STE 2
PORTSMOUTH NH
03801-2864
US

V. Phone/Fax

Practice location:
  • Phone: 317-838-9911
  • Fax: 317-837-6080
Mailing address:
  • Phone: 330-947-6021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71006888A
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: