Healthcare Provider Details

I. General information

NPI: 1578579991
Provider Name (Legal Business Name): HILMA M LEWIS CFNP APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6349 MAIN STREET PMS CUBA HEALTH CENTER CHECKERBOARD AREA HEALTH SERVIC
CUBA NM
87013
US

IV. Provider business mailing address

PO BOX 396
CUBA NM
87013
US

V. Phone/Fax

Practice location:
  • Phone: 505-289-3291
  • Fax: 505-289-9101
Mailing address:
  • Phone: 505-289-3291
  • Fax: 505-289-5101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR35426
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: