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Individual

REGINA L LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(866) 507-5244
(855) 851-4405
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN140448
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN140448
GA LIC NUMBER
GA
Enumeration date
07/23/2013
Last updated
11/17/2014
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