Individual
LATESHA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2153 FRANCIS AVE SE, GRAND RAPIDS, MI 49507-3016
(616) 405-0541
Mailing address
2153 FRANCIS AVE SE, GRAND RAPIDS, MI 49507-3016
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703122727
MI
Other
Enumeration date
06/01/2026
Last updated
06/01/2026
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