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1184995102 NPI number — GWENDOLYN JEANETTE LEWIS NP

NPI Number: 1184995102
Health Care Provider/Practitioner: GWENDOLYN JEANETTE LEWIS NP

Information about “1184995102” NPI (GWENDOLYN JEANETTE LEWIS NP) exists in 1184995102 in HTML format HTML  |  1184995102 in plain Text format TXT  |  1184995102 in PDF (Portable Document Format) PDF  |  1184995102 in an XML format XML  formats.

NPI Number : 1184995102 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184995102",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEWIS",
    "FirstName": "GWENDOLYN",
    "MiddleName": "JEANETTE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "902 MCCALLIE AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHATTANOOGA",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37403-2724",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "423-664-4460",
    "MailingAddressFaxNumber": "423-648-5675",
    "FirstLinePracticeLocationAddress": "1200 MEMORIAL DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DALTON",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30720-2529",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "423-664-4460",
    "PracticeLocationAddressFaxNumber": "423-648-5675",
    "EnumerationDate": "01/23/2012",
    "LastUpdateDate": "01/23/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LN0005X",
        "TaxonomyName": "Critical Care Neonatal Nurse Practitioner",
        "LicenseNumber": "RN120677",
        "LicenseNumberStateCode": "GA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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