Provider Demographics
NPI:1124868179
Name:SMITH, LAWON A (DONA CD)
Entity type:Individual
Prefix:MRS
First Name:LAWON
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:DONA CD
Other - Prefix:MRS
Other - First Name:LAWON
Other - Middle Name:A
Other - Last Name:SMITH-HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1420 N 39TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-2330
Mailing Address - Country:US
Mailing Address - Phone:773-754-9554
Mailing Address - Fax:
Practice Address - Street 1:6111 N TEUTONIA AVE STE 135
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-3646
Practice Address - Country:US
Practice Address - Phone:773-754-9554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL15383374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula