Healthcare Provider Details

I. General information

NPI: 1497905368
Provider Name (Legal Business Name): AMIE L LAWSON PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMIE L LARSON PA

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

95 TREMONT ST SUITE ONE
DUXBURY MA
02332-4738
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-0000
  • Fax:
Mailing address:
  • Phone: 781-934-2400
  • Fax: 781-934-0001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number055.0031813
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA001141
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: