Individual
REBECCA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402 FOREST RUN DR, EUREKA, MO 63025-2176
(314) 397-7015
Mailing address
402 FOREST RUN DR, EUREKA, MO 63025-2176
(314) 397-7015
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2013022209
MO
363LF0000X
Family Nurse Practitioner
Primary
2017029825
MO
Other
Enumeration date
11/05/2016
Last updated
08/18/2017
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