MEDICARE: LISA HEWSTON

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	376K00000X	Nurse's Aide	363816391189	OH

General Provider Information

NPI Number	:	1164240164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA HEWSTON

Provider Business Mailing Address
First Line	:	23900 CHAGRIN BLVD
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5511
Country	:	US
Telephone Number	:	216-464-1000
Fax Number	:	216-591-9244

Provider Business Practice Location Address
First Line	:	4675 E 153RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-3014
Country	:	US
Telephone Number	:	216-358-8548
Fax Number	:

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

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	09/30/2024

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Directions to “ LISA HEWSTON ” Practice Location

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