Individual
NICOLE RENAE LAWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
996 S STATE ROAD 135, GREENWOOD, IN 46143-7365
(317) 893-3888
(317) 893-3819
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085005263
IL
363A00000X
Physician Assistant
Primary
10002458A
IN
363A00000X
Physician Assistant
2013005681
MO
363A00000X
Physician Assistant
PA2015-0055
NM
Other
Enumeration date
01/12/2013
Last updated
06/03/2022
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