Healthcare Provider Details

I. General information

NPI: 1538706593
Provider Name (Legal Business Name): TORI MARIE LEWIS DAUPHINAIS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TORI MARIE LEWIS CRNP

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28227 THREE NOTCH RD
MECHANICSVILLE MD
20659-3239
US

IV. Provider business mailing address

28227 THREE NOTCH RD
MECHANICSVILLE MD
20659-3239
US

V. Phone/Fax

Practice location:
  • Phone: 301-884-8161
  • Fax: 301-475-7039
Mailing address:
  • Phone: 301-884-8161
  • Fax: 301-475-7039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR222774
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: