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General NPI Number Information
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NPI Number | 1780016782
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Entity Type | Individual
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Provider Name | AMANDA NICOLE LAWTON A.G.P.C.N.P.-BC
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Gender | Female
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Dates
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Enumeration Date | 08/01/2013
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 4660 KENMORE AVE SUITE 100
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1313
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Country | US
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Telephone | 703-751-5763
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Fax | 703-751-1152
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Provider Business Mailing Address
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Address Line | 4660 KENMORE AVE SUITE 100
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1313
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Country | US
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Telephone | 703-751-5763
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Fax | 703-751-1152
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0024171620
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 0024171620
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 0024171620
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F306606
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License Number State | NY
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