Doctor Name: | TENNIE CLARICE LEWIS |
NPI Number: | 1053454876 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | 0000105648 |
Business Practice Address: | 3439 New Hwy 68 Madisonville, TN - 37354 |
Business Phone Number: | 4234423993 |
Business Fax Number: | |
Mailing Address: | 137 Uphill Dr, MADISONVILLE |
State: | TN |
Postal Code: | 373545991 |
Phone Number: | 4234421235 |
Fax Number: | |
NPI Enumeration Date: | 02/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC1500X |
License Number: | 0000105648 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |