1700201035 NPI number — TAMI LAWSON APRN

Table of content: TAMI LAWSON APRN (NPI 1700201035)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700201035 NPI number — TAMI LAWSON APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAWSON
Provider First Name:
TAMI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GREEN
Provider Other First Name:
TAMI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700201035
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8105 NW EXPRESSWAY, SUITE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73162-6004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-602-3500
Provider Business Mailing Address Fax Number:
405-602-3550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8105 NW EXPRESSWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73162-6004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-602-3500
Provider Business Practice Location Address Fax Number:
405-602-3550
Provider Enumeration Date:
02/24/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  99221 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200525110A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com