Healthcare Provider Details

I. General information

NPI: 1942116892
Provider Name (Legal Business Name): MAKENNA LEWERS INC, HP, CPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 E KENWOOD ST
MESA AZ
85203-1876
US

IV. Provider business mailing address

732 E KENWOOD ST
MESA AZ
85203-1876
US

V. Phone/Fax

Practice location:
  • Phone: 281-757-6647
  • Fax:
Mailing address:
  • Phone: 281-757-6647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: