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General NPI Number Information
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NPI Number | 1982566733
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Entity Type | Individual
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Provider Name | SHAVONE JASMINE LEWIS RRT
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Gender | Female
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 44405 WOODWARD AVE FL 8
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City | PONTIAC
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State | MI
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Zip | 48341-5023
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Country | US
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Telephone | 248-452-5202
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Fax |
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Provider Business Mailing Address
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Address Line | 22131 AVON RD
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City | OAK PARK
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State | MI
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Zip | 48237-2573
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Country | US
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Telephone | 313-207-8088
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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 | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | 4401005393
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License Number State | MI
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