Individual
MRS. AMANDA LANE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP STE 105, SHREVEPORT, LA 71118-3175
(318) 797-2328
(318) 212-5674
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP STE 105, SHREVEPORT, LA 71118-3175
(318) 797-2328
(318) 212-5674
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07873
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2401521
—
LA
Enumeration date
06/23/2014
Last updated
04/25/2023
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