| Doctor Name: | AMANDA LAWSON |
| NPI Number: | 1376972869 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | 4704269680 |
| Business Practice Address: | 120 Waterstradt Commerce Dr Dundee, MI - 481319681 |
| Business Phone Number: | 7348235437 |
| Business Fax Number: | |
| Mailing Address: | 28224 Southpointe Rd, GROSSE ILE |
| State: | MI |
| Postal Code: | 481382024 |
| Phone Number: | 7062474939 |
| Fax Number: | |
| NPI Enumeration Date: | 11/05/2013 |
| NPI Last Update Date: | 11/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 4704269680 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |