Individual
MRS. AMY RENEE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., AGPCNP-BC
Contact information
Practice address
2800 E BROAD ST STE 517, MANSFIELD, TX 76063-6417
(817) 592-3360
(817) 549-5151
Mailing address
2800 E BROAD ST STE 517, MANSFIELD, TX 76063-6417
(817) 592-3360
(817) 549-5151
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP121311
TX
363LA2200X
Adult Health Nurse Practitioner
AP121311
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6R7554
GROUP MEDICARE PTAN
TX
01
—
BCBS
8XC231
TX
01
—
V0190197
TEXAS DEPARTMENT OF PUBLIC SAFETY (DPS) CONTROLLED SUBSTANCES REG.
TX
Enumeration date
01/20/2012
Last updated
06/27/2025
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