Individual
BRANDI NICOLE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN AAS
Contact information
Practice address
1048 16TH AVE S, SAINT CLOUD, MN 56301-5236
(320) 980-7490
Mailing address
1048 16TH AVE S, SAINT CLOUD, MN 56301-5236
(320) 980-7490
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L 062936-8
MN
Other
Enumeration date
11/14/2007
Last updated
11/14/2007
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