DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: KELLY JO LEWIS NURSE PRACTITIONER

MEDICARE: KELLY JO LEWIS NURSE PRACTITIONER
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
1363LP2300XPrimary Care Nurse Practitioner307837AZ

General Provider Information

NPI Number : 1104389451
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY JO LEWIS NURSE PRACTITIONER
Provider Business Mailing Address
First Line : PO BOX 1231
Second Line :
City : TUCSON
State : AZ
Zip : 85702-1231
Country : US
Telephone Number : 520-670-3909
Fax Number : 520-309-2560
Provider Business Practice Location Address
First Line : 1510 N STOCKTON HILL RD
Second Line :
City : KINGMAN
State : AZ
Zip : 86401-5173
Country : US
Telephone Number : 928-753-1177
Fax Number : 928-753-1177
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2019
Last Update Date : 05/01/2026

Similar Medicare Providers

1275527764 — MRS. KATHLEEN SUZANNE FLOREA NP
Practice Location Address:
1510 N STOCKTON HILL RD
KINGMAN, AZ
86401-5173
Practice Phone: 928-753-1177
Practice Fax: 928-718-4501
1376538389 — SUNGNAM JOE M.D.
Practice Location Address:
1510 N STOCKTON HILL RD
KINGMAN, AZ
86401-5173
Practice Phone: 928-753-1177
Practice Fax: 928-718-4501
1598703977 — DR. JOE REN'E SERNA M.D.
Practice Location Address:
1510 STOCKTON HILL RD
KINGMAN, AZ
86401-5173
Practice Phone: 928-753-1177
Practice Fax: 928-753-1178
1124254123 — DR. TIFFANY E RUSSELL MD
Practice Location Address:
1510 N STOCKTON HILL RD
KINGMAN, AZ
86401-5173
Practice Phone: 928-753-1177
Practice Fax:
1881912855 — CALEB HOLYOAK PHARM D
Practice Location Address:
1510 N STOCKTON HILL RD
KINGMAN, AZ
86401-5173
Practice Phone: 928-753-1177
Practice Fax:
1982016697 — NORTH COUNTRY HEALTH CARE
Practice Location Address:
1510 N STOCKTON HILL RD
KINGMAN, AZ
86401-5173
Practice Phone: 928-753-1177
Practice Fax:
1326418526 — MR. SEAN L'HUILLIER SR. FNP-C
Practice Location Address:
1510 N STOCKTON HILL RD
KINGMAN, AZ
86401-5173
Practice Phone: 928-753-1177
Practice Fax:

Directions to “ KELLY JO LEWIS NURSE PRACTITIONER” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.