Individual
AGNES CHAN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
12266 DE PAUL DR STE 205, BRIDGETON, MO 63044-2514
(314) 218-2300
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2011034516
MO
Other
Enumeration date
01/27/2012
Last updated
11/05/2020
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