MEDICARE: MS. LORRAINE JODY-ANN LEWIS

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	363LW0102X	Women's Health Nurse Practitioner	GAA-NP004211	GA
2	163W00000X	Registered Nurse	1-179771	AL

General Provider Information

NPI Number	:	1720865306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORRAINE JODY-ANN LEWIS

Provider Business Mailing Address
First Line	:	4171 LOMAC ST STE F
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36106-2945
Country	:	US
Telephone Number	:	334-578-7448
Fax Number	:

Provider Business Practice Location Address
First Line	:	4385 NARROW LANE RD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-2978
Country	:	US
Telephone Number	:	334-801-8134
Fax Number	:

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

Provider Enumeration Date	:	09/08/2023
Last Update Date	:	12/17/2025

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