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General NPI Number Information
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NPI Number | 1952874612
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Entity Type | Individual
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Provider Name | HEIDI K LEWIS DNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/05/2019
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 1525 ADDISON AVE E STE A2
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City | TWIN FALLS
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State | ID
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Zip | 83301-5300
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Country | US
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Telephone | 228-739-9961
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Fax | 208-739-9962
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Provider Business Mailing Address
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Address Line | 6405 S 3000 E STE 300
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City | SALT LAKE CITY
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State | UT
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Zip | 84121-6977
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Country | US
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Telephone | 801-266-3113
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Fax | 801-266-5633
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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 | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number | 60607
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP60917566
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 60607
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License Number State | ID
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