Individual
RUTHIE L LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
423A BEULAH AVENUE, TYLERTOWN, MS 39667
(601) 876-6169
(601) 876-6120
Mailing address
423A BEULAH AVENUE, TYLERTOWN, MS 39667
(601) 876-6169
(601) 876-6120
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P278719
MS
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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