MEDICARE: TENIELLE LAWSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	3010484	KY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	3010484	KY

General Provider Information

NPI Number	:	1881142834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TENIELLE LAWSON

Provider Business Mailing Address
First Line	:	41 DOGWOOD TRL
Second Line	:
City	:	LONDON
State	:	KY
Zip	:	40741-7511
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 W 5TH ST STE 2
Second Line	:
City	:	LONDON
State	:	KY
Zip	:	40741-1618
Country	:	US
Telephone Number	:	606-877-5277
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2016
Last Update Date	:	01/21/2026

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Directions to “ TENIELLE LAWSON ” Practice Location

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