Provider Demographics
NPI:1104982867
Name:LAWSON, EDWARD L (CRNA)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:L
Last Name:LAWSON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JOHN DEMPSEY HOSPITAL
Mailing Address - Street 2:263 FARMINGTON AVENUE, MC-2015
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-0001
Mailing Address - Country:US
Mailing Address - Phone:860-679-3516
Mailing Address - Fax:
Practice Address - Street 1:JOHN DEMPSEY HOSPITAL
Practice Address - Street 2:263 FARMINGTON AVENUE, MC-2015
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-0001
Practice Address - Country:US
Practice Address - Phone:860-679-3516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000204367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered