MEDICARE: GRACE JANE LAWSON DNP, AGACNP

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	363LA2100X	Acute Care Nurse Practitioner	205138	OK

General Provider Information

NPI Number	:	1962178582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE JANE LAWSON DNP, AGACNP

Provider Business Mailing Address
First Line	:	3001 QUAIL SPRINGS PKWY FL 5
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-2640
Country	:	US
Telephone Number	:	405-949-3417
Fax Number	:	405-552-5165

Provider Business Practice Location Address
First Line	:	3300 NW EXPRESSWAY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4418
Country	:	US
Telephone Number	:	405-949-3417
Fax Number	:	405-552-5165

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

Provider Enumeration Date	:	08/23/2021
Last Update Date	:	02/19/2026

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