Individual
IYSHA MICHELL LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5617 PRINCETON AVE, COLUMBUS, GA 31904-3480
(706) 257-7722
Mailing address
1701 37TH ST APT 504, PHENIX CITY, AL 36867-2595
(706) 405-5169
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2071814
AL
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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