Individual
ENID D LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1010 SPRUCE ST, ESPANOLA HOSPITAL, ESPANOLA, NM 87532-2724
(505) 753-7111
(505) 753-4438
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5654
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
525
NM
133VN1005X
Renal Nutrition Registered Dietitian
525
NM
207Q00000X
Family Medicine Physician
525
NM
Other
Enumeration date
03/02/2007
Last updated
04/20/2010
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