Individual
KRISTEN ANNE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 HOPE DR BLDG 6000, MOUNTAIN HOME A F B, ID 83648-1062
(208) 728-7401
Mailing address
90 HOPE DR BLDG 6000, MOUNTAIN HOME A F B, ID 83648-1062
(208) 728-7401
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
09/15/2009
Last updated
04/28/2011
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