MEDICARE: DR. DANIELLE LEWIS N.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	14-1422	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ND2200107	OTHER	DC	NATUROPATHIC PHYSICIAN
2	14-1422	OTHER	AZ	NATUROPATHIC PHYSICIAN
3	J00078	OTHER	MD	NATUROPATHIC PHYSICIAN

General Provider Information

NPI Number	:	1023197472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE LEWIS N.D.

Provider Business Mailing Address
First Line	:	210 E MORRIS DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2323
Country	:	US
Telephone Number	:	602-888-6883
Fax Number	:	888-332-3861

Provider Business Practice Location Address
First Line	:	2024 N 7TH ST STE 201
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2515
Country	:	US
Telephone Number	:	602-888-6883
Fax Number	:	888-332-3861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	02/15/2024

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