Healthcare Provider Details

I. General information

NPI: 1013295880
Provider Name (Legal Business Name): KATHY L LEWIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2011
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5710 OLEANDER DR STE 201
WILMINGTON NC
28403-4722
US

IV. Provider business mailing address

9 WALDEN RIDGE DR STE 10
ASHEVILLE NC
28803-8592
US

V. Phone/Fax

Practice location:
  • Phone: 833-365-7246
  • Fax:
Mailing address:
  • Phone: 833-365-7246
  • Fax: 828-348-4971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5005250
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5005250
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number79788
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: