Individual
JERRY WAYNE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN PMHNP-BC
Contact information
Practice address
103 SYCAMORE ST, LONDON, KY 40741-1740
(606) 312-4761
Mailing address
103 SYCAMORE ST, LONDON, KY 40741-1740
(606) 312-0779
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3017921
KY
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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