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NPI Code Detail

MEDICARE: CIERRA D LEWIS

MEDICARE: CIERRA D 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
1171M00000XCase Manager/Care Coordinator
2175T00000XPeer Specialist

Other Identifiers

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

General Provider Information

NPI Number : 1730729732
Entity Type Code : Individual
Provider Name (Legal Business Name) : CIERRA D LEWIS
Provider Business Mailing Address
First Line : 8326 KELWOOD AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-4803
Country : US
Telephone Number : 225-478-9685
Fax Number :
Provider Business Practice Location Address
First Line : 8326 KELWOOD AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-4803
Country : US
Telephone Number : 225-478-9635
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2020
Last Update Date : 03/17/2020

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Directions to “ CIERRA D LEWIS ” Practice Location

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