Individual
MRS. TAISHA A LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
720 SYCAMORE AVE, SOUTH MILWAUKEE, WI 53172-1338
(262) 385-9457
Mailing address
PO BOX 18733, MILWAUKEE, WI 53218-0733
(262) 385-9457
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
307107-031
WI
Other
Enumeration date
12/27/2010
Last updated
12/27/2010
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