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Individual

ANGELIA DENIESE LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.R.N.P.

Contact information

Practice address
251 N BAYOU ST, MOBILE, AL 36603
(251) 690-8894
(251) 544-2188
Mailing address
PO BOX 2867, MOBILE, AL 36652-2867
(251) 690-8894
(251) 544-2188

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP9232731
FL
363LF0000X
Family Nurse Practitioner
Primary
1-073404
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011846
MEDICARE GROUP NUMBER
AL
01
1063439065
GROUP NPI PAYEE NUMBER
AL
05
630000013
AL
01
Y083X
BCBS
FL
Enumeration date
01/20/2006
Last updated
05/21/2018
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