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NPI Code Detail

MEDICARE: CHARLETTA LEA LEWIS ARNP

MEDICARE: CHARLETTA LEA LEWIS ARNP
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
1163WP2201XAmbulatory Care Registered NurseRN00129609WA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAP60737780WA

General Provider Information

NPI Number : 1467508341
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLETTA LEA LEWIS ARNP
Provider Business Mailing Address
First Line : 14027 N FRIENDSHIP LN
Second Line :
City : NINE MILE FALLS
State : WA
Zip : 99026-8721
Country : US
Telephone Number : 509-290-2641
Fax Number :
Provider Business Practice Location Address
First Line : 1044 11TH AVE
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2506
Country : US
Telephone Number : 360-353-9422
Fax Number : 360-353-9526
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 12/06/2017

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Directions to “ CHARLETTA LEA LEWIS ARNP” Practice Location

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