Provider Demographics
NPI:1306912266
Name:ALLEN-LAWSON, SHIREEN KAY (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:SHIREEN
Middle Name:KAY
Last Name:ALLEN-LAWSON
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:SHIREEN
Other - Middle Name:KAY
Other - Last Name:WRIGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:3033 N CENTRAL AVE STE 145
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2808
Mailing Address - Country:US
Mailing Address - Phone:623-583-3001
Mailing Address - Fax:623-974-6721
Practice Address - Street 1:1705 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-6920
Practice Address - Country:US
Practice Address - Phone:480-964-2273
Practice Address - Fax:480-718-9477
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN-150122363LF0000X
AZAP1592363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1306912266Medicaid