Provider Demographics
NPI:1144181215
Name:LAWTON, BLAIR ASHLEY (APRN)
Entity type:Individual
Prefix:
First Name:BLAIR
Middle Name:ASHLEY
Last Name:LAWTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 BOULDER ROCK DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8533
Mailing Address - Country:US
Mailing Address - Phone:386-241-3837
Mailing Address - Fax:
Practice Address - Street 1:156 BOULDER ROCK DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8533
Practice Address - Country:US
Practice Address - Phone:386-241-3837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11043808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine