Individual
PATRICIA A LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1633 N CAPITOL AVE, STE 322, INDIANAPOLIS, IN 46202-1476
(317) 962-2929
(317) 962-2070
Mailing address
250 N SHADELAND AVE, STE 130 - PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28143276A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71003041A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200959620
—
IN
Enumeration date
08/28/2009
Last updated
09/25/2014
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