MEDICARE: LAWANDA L EWING MSN, CRNP, FNP-BC

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	363LF0000X	Family Nurse Practitioner	R201937	MD
2	363LF0000X	Family Nurse Practitioner	APRN11039588	FL

General Provider Information

NPI Number	:	1114672219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWANDA L EWING MSN, CRNP, FNP-BC

Provider Business Mailing Address
First Line	:	937 N SPRING GARDEN AVE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-2560
Country	:	US
Telephone Number	:	386-736-1948
Fax Number	:

Provider Business Practice Location Address
First Line	:	937 N SPRING GARDEN AVE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-2560
Country	:	US
Telephone Number	:	386-736-1948
Fax Number	:

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

Provider Enumeration Date	:	02/16/2022
Last Update Date	:	12/15/2025

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