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General NPI Number Information
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NPI Number | 1053835561
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Entity Type | Individual
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Provider Name | VERNICE LUEVINE LEWIS
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Gender | Female
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Dates
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Enumeration Date | 07/27/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11525 HIGHWAY ONE
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City | SOUTH HILL
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State | VA
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Zip | 23970
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Country | US
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Telephone | 804-586-8115
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Fax |
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Provider Business Mailing Address
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Address Line | 11525 HIGHWAY ONE
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City | SOUTH HILL
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State | VA
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Zip | 23970-5061
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Country | US
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Telephone | 804-586-8115
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | T69521324
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License Number State | VA
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