Individual
BRIONCCA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3716 ROUND HILL RD APT 7, SWANSEA, IL 62226-1226
(618) 977-4465
Mailing address
8520 ORLEANS LN, FORT WORTH, TX 76123-1637
(618) 977-4465
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2021026510
MO
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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