Individual
ALYSE NICOLE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5801 BREMO RD, RICHMOND EMERGENCY PHYSICIANS INC, RICHMOND, VA 23226-1907
(804) 287-7066
(804) 673-9531
Mailing address
6404 LAKESHORE DR, QUINTON, VA 23141-1204
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002313
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110002313
VA STATE LICENSE
VA
Enumeration date
09/15/2006
Last updated
08/21/2014
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