Individual
EQUILLA RENA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
103 COUNTRY CLUB DR, FAYETTEVILLE, NC 28301-7603
(910) 400-7002
Mailing address
PO BOX 746724, ATLANTA, GA 30374-6724
(312) 733-9730
(312) 733-9730
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5017121
NC
Other
Enumeration date
09/26/2022
Last updated
04/09/2024
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