Provider Demographics
NPI:1861894750
Name:LAWSON, MELISSA (RRT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-8409
Mailing Address - Country:US
Mailing Address - Phone:918-935-8790
Mailing Address - Fax:
Practice Address - Street 1:1124 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-8409
Practice Address - Country:US
Practice Address - Phone:918-935-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKRC14642279C0205X
CORTL37202279C0205X
TX743142279C0205X
FL114642279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care