Doctor Name: | LETASHA LEWIS |
NPI Number: | 1033476080 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, FNP-C |
License Number: | 16661 |
Business Practice Address: | 155 N Main St Suite 102a Collierville, TN - 380172676 |
Business Phone Number: | 9012834011 |
Business Fax Number: | |
Mailing Address: | 155 N Main St, Ste 102a COLLIERVILLE |
State: | TN |
Postal Code: | 380172650 |
Phone Number: | 9012834011 |
Fax Number: | |
NPI Enumeration Date: | 04/16/2012 |
NPI Last Update Date: | 03/30/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 16661 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |