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Individual

GINA M LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9000 W WISCONSIN AVE, PEDIATRIC HEMATOLOGY/ONCOLOGY, MILWAUKEE, WI 53226-4874
(414) 456-4170
(414) 456-6543
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC HEMATOLOGY/ONCOLOGY, MILWAUKEE, WI 53226-4874
(414) 456-4170
(414) 456-6543

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R1562738
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
3419-33
WI
363LP0200X
Pediatric Nurse Practitioner
9251522
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1982611570
WI
Enumeration date
08/03/2006
Last updated
04/11/2014
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