Individual
MS. DEBORAH MARIE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
106 E GILMER ST, BIG SANDY, TX 75755-2129
(903) 636-5366
(903) 636-4247
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-03595
NM
363LF0000X
Family Nurse Practitioner
454234
TX
363LF0000X
Family Nurse Practitioner
AP2731
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168784001
—
TX
Enumeration date
01/06/2006
Last updated
09/04/2018
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