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Individual

BRANDY LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LVN, DSD

Contact information

Practice address
624 E ELDER ST, FALLBROOK, CA 92028-3004
(760) 451-4165
Mailing address
24055 CLINTON KEITH RD APT 315, WILDOMAR, CA 92595-8530
(760) 497-5485

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
200727
CA

Other

Enumeration date
10/28/2021
Last updated
10/28/2021
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