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Individual
KELLI S LEWIS
Active
Individual
KELLI S LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LPN081542
GA
164W00000X
Licensed Practical Nurse
Primary
PN129053
OH
Other
Enumeration date
07/30/2010
Last updated
08/17/2011
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