=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457262248
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE LUPINE CENTER, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2026
-----------------------------------------------------
Last Update Date | 09/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1765 S 8TH ST STE 165
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80905-7910
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-631-8022
-----------------------------------------------------
Fax | 719-315-8237
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1765 S 8TH ST STE 165
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80905-7910
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-631-8022
-----------------------------------------------------
Fax | 719-315-8237
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SAMANTHA ANN LAWSON
-----------------------------------------------------
Credential | PMHNP
-----------------------------------------------------
Telephone | 719-631-8022
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------