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General NPI Number Information
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NPI Number | 1871983940
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Entity Type | Individual
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Provider Name | GINNA ASHLEY LEWIS MS, LAT, ATC, CSCS
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Gender | Female
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 400 ATLANTIC CHRISTIAN COL DR NE
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City | WILSON
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State | NC
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Zip | 27893-2575
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Country | US
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Telephone | 540-241-1664
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5000
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City | WILSON
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State | NC
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Zip | 27893-7000
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Country | US
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Telephone | 540-241-1664
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | LAT-2132
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License Number State | NC
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