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Individual

ANDREA MORGAN FORMYDUVAL LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4005 OLEANDER DR, WILMINGTON, NC 28403-6816
(910) 790-9949
(910) 790-9455
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
(910) 790-9455

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5004417
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7005679
NC
Enumeration date
07/13/2009
Last updated
08/14/2023
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