Doctor Name: | AUDREY LEWIS |
NPI Number: | 1336548924 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | 1-131286 |
Business Practice Address: | 299 Prairie St N Union Springs, AL - 360891618 |
Business Phone Number: | 3347387337 |
Business Fax Number: | 3345131665 |
Mailing Address: | 537 Park Lake Dr, MONTGOMERY |
State: | AL |
Postal Code: | 361177659 |
Phone Number: | 3342209389 |
Fax Number: | 3343562445 |
NPI Enumeration Date: | 08/19/2014 |
NPI Last Update Date: | 04/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-131286 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |