Provider Demographics
NPI:1053871863
Name:LAWSON, CARLA JEAN
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:JEAN
Last Name:LAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 COTTONWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-1012
Mailing Address - Country:US
Mailing Address - Phone:641-782-8754
Mailing Address - Fax:641-782-7048
Practice Address - Street 1:1003 COTTONWOOD RD
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-1012
Practice Address - Country:US
Practice Address - Phone:641-782-8754
Practice Address - Fax:641-782-7048
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA079785163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse