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General NPI Number Information
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NPI Number | 1700161072
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Entity Type | Individual
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Provider Name | NIKIYA L LEWIS
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Gender | Female
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Dates
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Enumeration Date | 10/18/2011
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 125B VICTORY DR
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City | SWAINSBORO
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State | GA
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Zip | 30401-3234
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Country | US
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Telephone | 478-419-1250
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 BRAMPTON AVE
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City | STATESBORO
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State | GA
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Zip | 30458-0851
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Country | US
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Telephone | 912-871-6206
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Fax | 912-681-8558
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN184063
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License Number State | GA
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