Healthcare Provider Details

I. General information

NPI: 1497413223
Provider Name (Legal Business Name): TAMARA LEE LEWIS MSN, RN, FNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 S QUEEN ST STE 102
DOVER DE
19904-3506
US

IV. Provider business mailing address

1340 MIDDLEFORD RD STE 401
SEAFORD DE
19973-3665
US

V. Phone/Fax

Practice location:
  • Phone: 302-601-0889
  • Fax: 866-229-0237
Mailing address:
  • Phone: 800-818-8680
  • Fax: 866-229-0237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0012358
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberL1-0033762
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: