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General NPI Number Information
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NPI Number | 1861127904
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Entity Type | Individual
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Provider Name | DENECIA LEWIS APRN
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Gender | Female
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Dates
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Enumeration Date | 07/21/2022
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5005 S COOPER ST STE 250
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City | ARLINGTON
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State | TX
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Zip | 76017-5996
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Country | US
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Telephone | 866-367-8768
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Fax |
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Provider Business Mailing Address
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Address Line | 2207 GREENSBOROUGH LN
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City | ARLINGTON
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State | TX
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Zip | 76001-6729
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Country | US
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Telephone | 903-920-4959
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1088213
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License Number State | TX
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