Individual
JENNIFER ASHLEY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 984-5104
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 984-2538
(601) 815-1854
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
R860115
MS
363LF0000X
Family Nurse Practitioner
Primary
R860115
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00803385
—
MS
Enumeration date
11/13/2009
Last updated
10/30/2014
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