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NPI Code Detail

MEDICARE: CHRISTINE G LEWIS

MEDICARE: CHRISTINE G 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
1364SP0808XPsychiatric/Mental Health Clinical Nurse Specialist0147991MN

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 : 1750430286
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE G LEWIS
Provider Business Mailing Address
First Line : 5340 COLFAX AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55419-1109
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5346 LYNDALE AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55419-1230
Country : US
Telephone Number : 612-823-3021
Fax Number : 612-746-5518
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 11/28/2016

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