Healthcare Provider Details

I. General information

NPI: 1427441419
Provider Name (Legal Business Name): LEKEISHA ANDERSON LEWIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2015
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4535 CHARING CROSS ST
MEMPHIS TN
38116-2009
US

IV. Provider business mailing address

4535 CHARING CROSS ST
MEMPHIS TN
38116-2009
US

V. Phone/Fax

Practice location:
  • Phone: 999-999-9999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000019774
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number19774
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAA004426
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: