Individual
ANNE ENSOR LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
6701 N CHARLES ST, SUITE 4105, BALTIMORE, MD 21204-6808
(443) 849-3184
(443) 849-3182
Mailing address
PO BOX 631568, BALTIMORE, MD 21263-1568
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R125808
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
467300000
—
MD
01
—
712L/144420YBPG
MEDICARE, STATE OF MD
MD
Enumeration date
01/25/2006
Last updated
01/13/2016
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