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Individual

SHASTA LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
X

Contact information

Practice address
1200A SPRING HILL AVE, MOBILE, AL 36604-2718
(251) 405-3677
(251) 405-3233
Mailing address
PO BOX 41241, MOBILE, AL 36640-1241
(251) 405-3677
(251) 405-3233

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
1-204902
AL

Other

Enumeration date
10/24/2025
Last updated
10/24/2025
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