Healthcare Provider Details

I. General information

NPI: 1013044205
Provider Name (Legal Business Name): JUNE LEWIS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BLYTHEWOOD DR
COLUMBIA TN
38401-4828
US

IV. Provider business mailing address

11 MARCELLA FALLS RD
ETHRIDGE TN
38456-5031
US

V. Phone/Fax

Practice location:
  • Phone: 931-388-5757
  • Fax:
Mailing address:
  • Phone: 931-829-5235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0000094515
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: