Individual
TERESA LYNN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2400 SAGAMORE PKWY S, LAFAYETTE, IN 47905-5116
(765) 772-4086
(765) 772-4086
Mailing address
223 S BROOKFIELD DR, LAFAYETTE, IN 47905-7223
(765) 426-6339
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
71001192A
IN
363L00000X
Nurse Practitioner
Primary
71001192A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200880950
—
IN
Enumeration date
07/12/2006
Last updated
06/06/2022
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