Individual
MRS. HALEY SELLERS LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
100 DOCTORS DR, SUITE G, DOUGLAS, GA 31533-2210
(912) 384-9898
Mailing address
PO BOX 1377, DOUGLAS, GA 31535-1377
(912) 384-1477
(912) 384-1470
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN227519
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003186616A
—
GA
01
—
RN227519
MEDICAL LICENSE
GA
Enumeration date
01/10/2017
Last updated
09/06/2017
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