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NPI Code Detail

MEDICARE: PHOEBE LEWIS

MEDICARE: PHOEBE LEWIS
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1073342150
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHOEBE LEWIS
Provider Business Mailing Address
First Line : 284 NORTH ST
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-3637
Country : US
Telephone Number : 202-957-2553
Fax Number :
Provider Business Practice Location Address
First Line : 163 VETERANS DR
Second Line :
City : WHITE RIVER JUNCTION
State : VT
Zip : 05001-7005
Country : US
Telephone Number : 802-257-9363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2024
Last Update Date : 07/29/2024

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Directions to “ PHOEBE LEWIS ” Practice Location

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