Individual
ELLEN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
367 ATHENS HWY, STE 1050, LOGANVILLE, GA 30052-2204
(770) 554-2999
Mailing address
1540 RUNNYMEDE CT SW, LILBURN, GA 30047-3300
(770) 982-7516
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN116778
GA
Other
Enumeration date
04/14/2008
Last updated
10/31/2014
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