Individual
ROBERTA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1516 GRAVIER ST, NEW ORLEANS, LA 70112
(504) 517-1815
Mailing address
2004 DESIRE ST., NEW ORLEANS, LA 70117
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20131041
LA
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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