Individual
JESSICA LYNN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4373-033
WI
367500000X
Certified Registered Nurse Anesthetist
4704242414
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100013521
—
WI
05
—
1245489145
—
WI
Enumeration date
09/16/2008
Last updated
01/29/2024
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