Healthcare Provider Details

I. General information

NPI: 1619702776
Provider Name (Legal Business Name): ULUNMA LAWSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 WELDON SPRING PKWY
WELDON SPRING MO
63304-9101
US

IV. Provider business mailing address

3016 EAGLE BRANCH CIR
SAINT PAUL MO
63366-1529
US

V. Phone/Fax

Practice location:
  • Phone: 636-441-7300
  • Fax: 636-477-2107
Mailing address:
  • Phone: 314-685-7998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025039577
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2020002296
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: