Individual
KETRINA E LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2965
Mailing address
809 N CENTRAL EXPY, MCKINNEY, TX 75070-3303
(972) 529-4500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP143211
TX
363LP2300X
Primary Care Nurse Practitioner
CNP-03123
NM
Other
Enumeration date
10/13/2017
Last updated
11/08/2019
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