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General NPI Number Information
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NPI Number | 1588188122
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Entity Type | Individual
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Provider Name | JENNIFER J LEWIS NP
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Gender | Female
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 20209 SENTARA WAY STE 100
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City | CARROLLTON
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State | VA
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Zip | 23314-3573
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Country | US
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Telephone | 757-772-6125
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Fax | 757-267-9196
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Provider Business Mailing Address
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Address Line | 4897 BENNETTS PASTURE RD
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City | SUFFOLK
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State | VA
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Zip | 23435-1373
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Country | US
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Telephone | 571-425-1881
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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 | R184603
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024174863
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License Number State | VA
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