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Individual

LATINA LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3501 S SONCY RD STE 110, AMARILLO, TX 79119-6405
(806) 353-1400
(806) 353-1404
Mailing address
PO BOX 8337, AMARILLO, TX 79114-8337
(806) 355-6593
(806) 352-8774

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1005240
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1005240
APRN-CNP
TX
01
787728
RN
TX
Enumeration date
07/24/2020
Last updated
07/24/2020
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