Individual
MR. MICHAEL JEFF LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
905 CRESCENT RD, SHREVEPORT, LA 71107-3908
(318) 617-5563
Mailing address
PO BOX 1350, MINDEN, LA 71058-1350
(318) 617-5563
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
TAP002239
LA
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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