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Individual
SAMANTHA RAQUEL LEWIS
Active
Individual
SAMANTHA RAQUEL LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
145622
CT
163WG0000X
General Practice Registered Nurse
517976-1
NY
363L00000X
Nurse Practitioner
7304
CT
363LC1500X
Community Health Nurse Practitioner
320051
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401200
NY
Other
Enumeration date
07/19/2006
Last updated
07/23/2018
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