Individual
KELLY A LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
19714 E 10 MILE RD, SAINT CLAIR SHORES, MI 48080-1064
(586) 779-9400
Mailing address
19714 E 10 MILE RD, SAINT CLAIR SHORES, MI 48080-1064
(248) 909-1067
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
4704271476
MI
363L00000X
Nurse Practitioner
Primary
4704271476
MI
367A00000X
Advanced Practice Midwife
4704271476
MI
Other
Enumeration date
09/25/2016
Last updated
03/03/2025
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