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General NPI Number Information
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NPI Number | 1932689965
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Entity Type | Organization
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Legal Business Name | LEWIS MEDICAL OF NORTHEAST LOUISIANA
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Dates
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Enumeration Date | 08/20/2018
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Last Update Date | 08/20/2018
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Provider Practice Location Address
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Address Line | 470 SPRINGHILL RD
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City | MONROE
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State | LA
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Zip | 71203-9696
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Country | US
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Telephone | 318-372-8925
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Fax |
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Provider Business Mailing Address
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Address Line | 470 SPRINGHILL RD
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City | MONROE
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State | LA
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Zip | 71203-9696
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | BRENDA K ROBERTS
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Credential |
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Telephone | 318-381-4759
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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 | F0806153
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License Number State | LA
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