Healthcare Provider Details

I. General information

NPI: 1023925674
Provider Name (Legal Business Name): KATIE LAURYN LEWIS APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 BLUE RIDGE DR STE 201
GEORGETOWN TX
78626-1002
US

IV. Provider business mailing address

1502 BLUE RIDGE DR STE 201
GEORGETOWN TX
78626-1002
US

V. Phone/Fax

Practice location:
  • Phone: 800-215-3219
  • Fax: 346-245-8026
Mailing address:
  • Phone: 800-215-3219
  • Fax: 346-245-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number244179
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: