Provider Demographics
NPI:1699491480
Name:LAWSON, KATHY L
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:L
Last Name:LAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATIANNA
Other - Middle Name:L
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1405 VEGAS VALLEY DR APT 160
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-2205
Mailing Address - Country:US
Mailing Address - Phone:702-619-2471
Mailing Address - Fax:
Practice Address - Street 1:1771 E FLAMINGO RD STE 220A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0850
Practice Address - Country:US
Practice Address - Phone:702-560-2192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide