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Individual

AVERETTA E LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1525 W CARO RD, CARO, MI 48723-9686
(989) 672-2100
(989) 672-0748
Mailing address
3785 BAY RD, SAGINAW, MI 48603-2433
(989) 791-2455
(989) 791-1392

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704138338
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0876899
BCBSM
MI
05
1245328210
MI
05
1982854451
MI
05
4948182
MI
Enumeration date
10/11/2006
Last updated
11/16/2017
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