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General NPI Number Information
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NPI Number | 1184297798
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Entity Type | Individual
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Provider Name | MEGAN BROOKE LEWIS APRN,FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 1400 S LYNN LN
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City | IDABEL
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State | OK
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Zip | 74745-6858
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Country | US
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Telephone | 580-286-6628
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Fax | 580-286-2012
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Provider Business Mailing Address
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Address Line | 610 GRAY LN
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City | KERENS
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State | TX
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Zip | 75144-2014
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Country | US
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Telephone | 903-467-6704
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 204580
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License Number State | OK
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