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General NPI Number Information
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NPI Number | 1346968146
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Entity Type | Individual
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Provider Name | ANNA CATHERINE LEWIS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/17/2022
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 1017 W BEACON ST
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City | PHILADELPHIA
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State | MS
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Zip | 39350-3218
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Country | US
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Telephone | 769-200-0730
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Fax |
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Provider Business Mailing Address
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Address Line | 415 JACKSON STEPHENS RD
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City | DE KALB
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State | MS
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Zip | 39328-7521
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Country | US
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Telephone | 601-562-6359
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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 | 905481
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License Number State | MS
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