Healthcare Provider Details

I. General information

NPI: 1174253355
Provider Name (Legal Business Name): KRISTEN LEWKOVICH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CONNECTICUT AVE NW APT 512
WASHINGTON DC
20008-6118
US

IV. Provider business mailing address

2000 CONNECTICUT AVE NW APT 512
WASHINGTON DC
20008-6118
US

V. Phone/Fax

Practice location:
  • Phone: 703-888-6698
  • Fax:
Mailing address:
  • Phone: 703-888-6698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR253121
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN200005292
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number0001274032
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ15600300
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number769229
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024190624
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: