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NPI 1487769501

NPI 1487769501 : WENDY PAYNE LEWIS A.N.P. : CHARLOTTE, NC

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General NPI Number Information
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    NPI Number           |    1487769501
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    Entity Type          |    Individual 
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    Provider Name        |    WENDY PAYNE LEWIS A.N.P.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/20/2006
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    Last Update Date     |    04/24/2018
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Provider Practice Location Address
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    Address Line         |    7845 LITTLE AVE 
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28226-8198
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    Country              |    US
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    Telephone            |    704-375-0100
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    Fax                  |    704-335-3592
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Provider Business Mailing Address
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    Address Line         |    PO BOX 470408 
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28247-0408
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    Country              |    US
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    Telephone            |    704-375-0100
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    Fax                  |    704-335-3592
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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        |    363LA2200X
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    Taxonomy Name        |    Adult Health Nurse Practitioner
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    License Number       |    900353
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    License Number State |    NC
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