Individual
JERRY MADISON LEWTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3726 ASHFORD DUNWOODY RD NE, APT N, ATLANTA, GA 30319-1873
(678) 404-2343
Mailing address
3726 ASHFORD DUNWOODY RD NE, APT N, ATLANTA, GA 30319-1873
(678) 404-2343
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN158379
GA
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN158379
GA
163WG0000X
General Practice Registered Nurse
RN158379
GA
163WH0200X
Home Health Registered Nurse
RN158379
GA
163WH0500X
Hemodialysis Registered Nurse
RN158379
GA
163WP0200X
Pediatric Registered Nurse
RN158379
GA
163WW0000X
Wound Care Registered Nurse
RN158379
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN158379
RN LICENSE
GA
Enumeration date
04/18/2006
Last updated
03/27/2011
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