Healthcare Provider Details

I. General information

NPI: 1184137028
Provider Name (Legal Business Name): ERIN TATE LAWSON MSN, BSN, RN, CN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN LEA TATE MSN, BSN, RN, CN

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3306 WILSON AVE
LYNCHBURG VA
24501-6219
US

IV. Provider business mailing address

3306 WILSON AVE
LYNCHBURG VA
24501-6219
US

V. Phone/Fax

Practice location:
  • Phone: 336-380-9074
  • Fax:
Mailing address:
  • Phone: 336-380-9074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001242605
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: