Individual
MS. MARISSA JONES LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN RN, RDH
Contact information
Practice address
2005 MCDOWELL ST, AUGUSTA, GA 30904-4182
(912) 424-9014
Mailing address
2005 MCDOWELL ST, AUGUSTA, GA 30904-4182
(912) 424-9014
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
003661
FM
163W00000X
Registered Nurse
Primary
165342
GA
Other
Enumeration date
11/24/2009
Last updated
11/24/2009
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