Individual
JESSICA ANNE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501
(208) 750-7445
(208) 750-7395
Mailing address
415 6TH STREET, ATTN: PHYSICIAN SERVICES, LEWISTON, ID 83501-2434
(208) 750-7462
(208) 750-7467
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
35472
TN
363LF0000X
Family Nurse Practitioner
Primary
78877
ID
Other
Enumeration date
03/08/2024
Last updated
12/27/2024
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