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General NPI Number Information
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NPI Number | 1306545454
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Entity Type | Individual
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Provider Name | MARLENA R LEWIS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 2129 OSUNA RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-1002
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Country | US
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Telephone | 505-300-1760
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Fax | 505-217-0429
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Provider Business Mailing Address
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Address Line | 2262 ESCUDO RD NE
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City | RIO RANCHO
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State | NM
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Zip | 87124-8932
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Country | US
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Telephone | 505-414-6775
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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 | 55291
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License Number State | NM
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