Healthcare Provider Details

I. General information

NPI: 1932249059
Provider Name (Legal Business Name): SUSAN M. LAWLOR C.R.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

528 WASHINGTON HIGHWAY
MORRISVILLE VT
05661-8973
US

IV. Provider business mailing address

528 WASHINGTON HIGHWAY
MORRISVILLE VT
05661-8973
US

V. Phone/Fax

Practice location:
  • Phone: 802-888-4231
  • Fax: 802-888-8203
Mailing address:
  • Phone: 802-888-4231
  • Fax: 802-888-8203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1010026256
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number101-0026256
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: