Individual
KATHLEEN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
46961 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48317
(586) 991-5205
Mailing address
517 HAWTHORN AVE, ROYAL OAK, MI 48067-3619
(248) 376-0908
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704313036
MI
Other
Enumeration date
07/14/2019
Last updated
07/18/2019
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