Individual
DANIELLE DIANE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
623 W MAIN ST, TUPELO, MS 38804-3759
(662) 397-7794
Mailing address
4174 HIGHWAY 278, SULLIGENT, AL 35586-4525
(205) 712-5114
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905531
MS
Other
Enumeration date
09/02/2022
Last updated
09/22/2022
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