Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | R213549 | MD |
NPI | 1003403031 |
---|---|
Provider Name | Kamiylah Lawson |
First Address | Parkville, MD 21234-9128 |
Second Address | Towson, MD 21204-6819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2020 |
Last Update Date | 12/04/2021 |