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General NPI Number Information
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NPI Number | 1831962752
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Entity Type | Individual
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Provider Name | JENNIFER SUE LAWSON CPNP
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Gender | Female
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Dates
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Enumeration Date | 11/02/2023
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 303 N KEENE ST
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City | COLUMBIA
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State | MO
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Zip | 65201-8050
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Country | US
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Telephone | 573-777-7627
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Fax |
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Provider Business Mailing Address
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Address Line | 941 WINDSET CT
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City | CENTRALIA
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State | MO
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Zip | 65240-4145
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Country | US
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Telephone | 573-819-5004
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Fax |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 2023044241
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License Number State | MO
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