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Individual
MARY B. LEWIS
Active
Individual
MARY B. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000994A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000550574
ANTHEM BLUE CROSS
IN
05
—
200932700
—
IN
01
—
P00626250
RAILROAD MEDICARE
IN
Enumeration date
09/21/2007
Last updated
10/28/2011
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