Individual
MARY E. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
73538
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WV4776A
PALMETTO GBA- PTAN
WV
Enumeration date
08/15/2014
Last updated
10/31/2024
Update your record
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