Individual
KATHERINE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4111 N PORT WASHINGTON RD, MILWAUKEE, WI 53212-1029
(414) 299-3872
(414) 455-1929
Mailing address
N24W24050 BRANDON OAKS DR UNIT A, PEWAUKEE, WI 53072-6429
(915) 873-9641
(262) 373-0148
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3751-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA.0004076
COLORADO MEDICAL LICENSE
CO
Enumeration date
11/25/2014
Last updated
11/16/2018
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