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General NPI Number Information
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NPI Number | 1003118043
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Entity Type | Individual
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Provider Name | LINDSEY MARIE LAWLESS MS, PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/24/2010
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 301 E 2ND ST
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-1900
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Country | US
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Telephone | 608-647-6161
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Fax | 608-647-3178
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Provider Business Mailing Address
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Address Line | 301 E 2ND ST
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-1900
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Country | US
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Telephone | 608-647-6161
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Fax | 608-647-3178
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C04408
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2720-23
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License Number State | WI
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