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General NPI Number Information
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NPI Number | 1841392602
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Entity Type | Individual
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Provider Name | SALLY ANN LEWIS ANP-BC, ACNP-BC,APRN
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Gender | Female
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 03/07/2011
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Provider Practice Location Address
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Address Line | 1500 WEISS ST
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City | SAGINAW
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State | MI
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Zip | 48602-5251
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Country | US
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Telephone | 989-497-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 1185 W TOWNLINE 16 RD
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City | PINCONNING
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State | MI
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Zip | 48650-7992
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Country | US
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Telephone | 989-879-4196
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4704134115
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License Number State | MI
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