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Individual

GERALD C LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNS, BC

Contact information

Practice address
9120 CONNECTICUT ST STE A, MERRILLVILLE, IN 46410-7015
(219) 793-1233
(219) 793-1244
Mailing address
9120 CONNECTICUT ST STE A, MERRILLVILLE, IN 46410-7015
(219) 793-1233

Taxonomy

Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
70000167
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01054054
RR MEDICARE
IN
Enumeration date
09/24/2006
Last updated
11/13/2023
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