Provider Demographics
NPI:1366569816
Name:LAWSON, KAREN ELAINE (PT, MSPT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ELAINE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 SHAMROCK DR
Mailing Address - Street 2:SUITES 100-102
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7325
Mailing Address - Country:US
Mailing Address - Phone:812-479-7337
Mailing Address - Fax:812-471-6650
Practice Address - Street 1:4900 SHAMROCK DR
Practice Address - Street 2:SUITES 100-102
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7325
Practice Address - Country:US
Practice Address - Phone:812-479-7337
Practice Address - Fax:812-550-1990
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05004421A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200174300BMedicaid
ININ PROCESSMedicaid
IN200174300BMedicaid