Individual
DIANE LEWTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 432-2297
(260) 434-6420
Mailing address
6920 POINTE INVERNESS WAY, STE 200, FORT WAYNE, IN 46804-7934
(260) 432-2297
(260) 434-6420
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000599
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000291182
ANTHEM
IN
05
—
200321230
—
IN
05
—
2463892
—
OH
01
—
500016270
RAILROAD
—
01
—
LENP15741
MEDICAID-VANWERT
OH
01
—
LENP15742
MEDICAID-PAULDING
OH
Enumeration date
03/20/2006
Last updated
05/31/2011
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