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General NPI Number Information
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NPI Number | 1770475063
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Entity Type | Individual
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Provider Name | MICHELLE LEWIS
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Gender | Female
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Dates
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Enumeration Date | 07/19/2025
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Last Update Date | 07/19/2025
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Provider Practice Location Address
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Address Line | 26317 WASHINGTON ST
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City | NORTH DINWIDDIE
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State | VA
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Zip | 23803-2727
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Country | US
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Telephone | 804-524-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 34382
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23234-0382
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Country | US
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Telephone | 804-536-4050
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 24194082
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License Number State | VA
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