Individual
JUDITH G LEWALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
100 JESSIE JAMES BLVD, PINEVILLE, MO 64856
(417) 223-7050
(417) 223-7055
Mailing address
100 JESSIE JAMES BLVD, PINEVILLE, MO 64856
(417) 223-7050
(417) 223-7055
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1028
AK
363LF0000X
Family Nurse Practitioner
085477
MO
363LF0000X
Family Nurse Practitioner
Primary
A03622
AR
Other
Enumeration date
07/22/2005
Last updated
10/26/2012
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