Individual
MRS. SHAUNDA L. LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.P.R.N., B.C.
Contact information
Practice address
644 HIGHWAY 114 S, SCOTTS HILL, TN 38374-5023
(731) 549-3191
(731) 549-3005
Mailing address
644 HIGHWAY 114 S, P. O. BOX 99, SCOTTS HILL, TN 38374-5023
(731) 549-3191
(731) 549-3005
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APN0000005099
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3341695
—
TN
01
—
4035615
BLUE CROSS BLUE SHIELD OF
TN
Enumeration date
12/06/2005
Last updated
05/24/2011
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