Individual
DORNEL J LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
2808 E ATLANTA RD, SUITE 344, ELLENWOOD, GA 30294-2780
(404) 434-0401
Mailing address
304 SUMMIT HEIGHTS CT, ELLENWOOD, GA 30294-2973
(404) 254-8250
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN248615
GA
363L00000X
Nurse Practitioner
Primary
RN248615
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN248615
GA
Other
Enumeration date
01/25/2006
Last updated
12/19/2025
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