Individual
DEANNA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 GRANT AVE, JONESBORO, AR 72401-6155
(870) 974-9114
(870) 974-9184
Mailing address
1801 GRANT AVE, JONESBORO, AR 72401-6155
(870) 974-9114
(870) 974-9184
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198456795
—
AR
Enumeration date
01/23/2014
Last updated
07/21/2022
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