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Individual

REBEKAH DANIELLE LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
945 W RUSSELL ST, ELKHORN CITY, KY 41522-9032
(800) 226-8874
(877) 366-4776
Mailing address
3800 S OCEAN DR STE 209, HOLLYWOOD, FL 33019-2915
(800) 226-8874

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2883
KY
363A00000X
Physician Assistant
PA9115144
FL
363AM0700X
Medical Physician Assistant
0110009460
VA
363AM0700X
Medical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA2883
KY STATE LICENSE
KY
Enumeration date
06/17/2020
Last updated
04/07/2025
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