Individual
MRS. DIANNE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN-BC
Contact information
Practice address
450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
(770) 313-7378
Mailing address
663 OLD MOUNTAIN RD NW, KENNESAW, GA 30152-3840
(770) 224-1732
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN148704
GA
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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