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NPI Code Detail

MEDICARE: CARMEN SYDNI LEWIS PA

MEDICARE: CARMEN SYDNI LEWIS PA
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
1363A00000XPhysician Assistant6146TN

General Provider Information

NPI Number : 1265164123
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN SYDNI LEWIS PA
Provider Business Mailing Address
First Line : 221 STERLING FARM DR
Second Line :
City : JACKSON
State : TN
Zip : 38305-5727
Country : US
Telephone Number : 731-300-6163
Fax Number : 731-300-6955
Provider Business Practice Location Address
First Line : 221 STERLING FARM DR
Second Line :
City : JACKSON
State : TN
Zip : 38305-5727
Country : US
Telephone Number : 731-300-6163
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2022
Last Update Date : 12/17/2024

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Directions to “ CARMEN SYDNI LEWIS PA” Practice Location

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