Individual
CHERYL MARIE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
633 TREEHOUSE CIR, SAINT AUGUSTINE, FL 32095-6837
(904) 860-4066
Mailing address
633 TREEHOUSE CIR, SAINT AUGUSTINE, FL 32095-6837
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
1431182
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1431182
STATE BOARD
FL
Enumeration date
02/01/2022
Last updated
02/01/2022
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