MEDICARE: LEWIS MITCHELL SHARP ARNP, CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	21207	TN
2	367500000X	Certified Registered Nurse Anesthetist	9325734	FL

General Provider Information

NPI Number	:	1033590526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEWIS MITCHELL SHARP ARNP, CRNA

Provider Business Mailing Address
First Line	:	198 SW GOVERNORS GLN
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32024-1768
Country	:	US
Telephone Number	:	386-623-2899
Fax Number	:

Provider Business Practice Location Address
First Line	:	198 SW GOVERNORS GLN
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32024-1768
Country	:	US
Telephone Number	:	386-623-2899
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2015
Last Update Date	:	03/27/2024

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