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General NPI Number Information
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NPI Number | 1073391959
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Entity Type | Individual
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Provider Name | KARLIE LEWIS PNP-PC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2023
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 890 ROCKWALL PKWY STE 100
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City | ROCKWALL
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State | TX
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Zip | 75032-6871
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Country | US
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Telephone | 214-306-4456
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Fax |
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Provider Business Mailing Address
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Address Line | 409 CHASE CREEK DR
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City | LAVON
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State | TX
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Zip | 75166-4724
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Country | US
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Telephone | 214-543-7810
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 1128346
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License Number State | TX
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