Individual
MRS. LOIS ELAINE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN NURSE PRACTITIONE
Contact information
Practice address
205 W GRANGER AVE, MODESTO, CA 95350
(209) 579-9930
(209) 579-9941
Mailing address
2617 SURREY AVE, MODESTO, CA 95355
(209) 529-1556
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5066
CA
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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