Individual
MRS. BLAKELEY MADISON LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
636 S MONTE VISTA DR, GLADE SPRING, VA 24340-2712
(276) 429-5163
Mailing address
728 SUNSET DR, CHILHOWIE, VA 24319-4504
(423) 356-7739
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024174992
VA
Other
Enumeration date
06/25/2017
Last updated
06/25/2017
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