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NPI Code Detail

MEDICARE: CARRIE L LEWIS CNA

MEDICARE:   CARRIE L LEWIS  CNA
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
1376K00000XNurse's AideIL

General Provider Information

NPI Number : 1073233698
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE L LEWIS CNA
Provider Business Mailing Address
First Line : 13102 HOYNE AVE APT 2
Second Line :
City : BLUE ISLAND
State : IL
Zip : 60406-4857
Country : US
Telephone Number : 601-641-1845
Fax Number :
Provider Business Practice Location Address
First Line : 13102 HOYNE AVE APT 2
Second Line :
City : BLUE ISLAND
State : IL
Zip : 60406-4857
Country : US
Telephone Number : 601-641-1845
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2022
Last Update Date : 09/01/2022

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Directions to “ CARRIE L LEWIS CNA” Practice Location

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