Healthcare Provider Details

I. General information

NPI: 1508788845
Provider Name (Legal Business Name): VALERIE WILDING LEWIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1845N GREENVILLE RD
BRISTOLVILLE OH
44402-9700
US

IV. Provider business mailing address

2605 FOREST SPRINGS DR SE
WARREN OH
44484-5624
US

V. Phone/Fax

Practice location:
  • Phone: 330-880-1079
  • Fax:
Mailing address:
  • Phone: 330-240-3831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN-241826
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: