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NPI Code Detail

MEDICARE: MRS. MICHELE THERESE LEWIS CRNA

MEDICARE: MRS. MICHELE THERESE LEWIS 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
1367500000XCertified Registered Nurse Anesthetist121721NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2D3601OTHERNCMEDCOST

General Provider Information

NPI Number : 1700886611
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELE THERESE LEWIS CRNA
Provider Business Mailing Address
First Line : PO BOX 890235
Second Line :
City : CHARLOTTE
State : NC
Zip : 28289-0235
Country : US
Telephone Number : 800-919-1190
Fax Number : 800-919-1190
Provider Business Practice Location Address
First Line : 607 BEAMAN ST
Second Line : ANESTHESIA DEPARTMENT
City : CLINTON
State : NC
Zip : 28328-2603
Country : US
Telephone Number : 910-592-8511
Fax Number : 910-592-8511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 05/22/2008

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