Individual
JESSICA T LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15 S GATEWAY DR STE 101, FREDERICKSBURG, VA 22406-1231
(540) 368-5603
Mailing address
15 S GATEWAY DR STE 101, FREDERICKSBURG, VA 22406-1231
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110008466
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619625324
—
VA
05
—
30017471110007
—
VA
Enumeration date
03/11/2022
Last updated
08/21/2025
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