Individual
JESSICA D. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 HARBOUR WAY, MILTON, WV 25541
(304) 743-1407
(304) 743-4516
Mailing address
2585 3RD AVE, HUNTINGTON, WV 25703-1642
(304) 697-1396
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71360
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0295267
—
OH
05
—
1659721496
—
WV
Enumeration date
06/13/2016
Last updated
08/07/2018
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