Individual
STACEY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4040 N MARTIN L KING BLVD STE A, NORTH LAS VEGAS, NV 89032-3205
(702) 644-4673
(702) 902-5443
Mailing address
2760 LAKE SAHARA DR, SUITE 108, LAS VEGAS, NV 89117-3438
(702) 222-0792
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
NV
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
05/24/2011
Last updated
11/25/2024
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