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Individual

MRS. SUMMER RENEA LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CST,CFA

Contact information

Practice address
3 AUDUBON PLAZA DR STE 560, LOUISVILLE, KY 40217-1376
(502) 636-8004
(502) 636-8384
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA055
KY
246ZS0410X
Surgical Technologist
89182
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000358027
246Z50400X
KY
Enumeration date
02/02/2007
Last updated
09/30/2019
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