Provider Demographics
NPI:1194375667
Name:LAWSON, NATHAN ANDREW
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:ANDREW
Last Name:LAWSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2336 E LIBRA PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-3790
Mailing Address - Country:US
Mailing Address - Phone:480-747-0987
Mailing Address - Fax:
Practice Address - Street 1:2336 E LIBRA PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-3790
Practice Address - Country:US
Practice Address - Phone:480-747-0987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians