Individual
JESSICA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1201 CAMINO DE SALUD NE, ALBUQUERQUE, NM 87102-4517
(505) 272-4946
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
014502
NY
363A00000X
Physician Assistant
Primary
PA2017-0025
NM
Other
Enumeration date
12/02/2010
Last updated
09/11/2024
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