Provider Demographics
NPI:1447080866
Name:LAWSON, CRYSTAL (RN, BSN)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4613 W MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-2698
Mailing Address - Country:US
Mailing Address - Phone:269-250-8868
Mailing Address - Fax:
Practice Address - Street 1:4613 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-2698
Practice Address - Country:US
Practice Address - Phone:269-250-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704323473163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care