Individual
JACQUELINE LENORE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
197 E AIKEN RD, EDEN, NC 27288-2201
(336) 623-7715
Mailing address
PO BOX 1115, REIDSVILLE, NC 27323-1115
(336) 589-8197
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
FCL-079-056
NC
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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