Individual
BEVERLY A LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1058 E WORTHY ST STE B, GONZALES, LA 70737-4302
(225) 258-7322
(225) 450-3799
Mailing address
1058 E WORTHY ST STE B, GONZALES, LA 70737-4302
(225) 258-7322
(225) 450-3799
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13669815587
—
LA
Enumeration date
12/06/2017
Last updated
12/06/2017
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