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NPI Code Detail

MEDICARE: DORINDA LEWIS DEW FNP

MEDICARE: DORINDA LEWIS DEW FNP
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
1363LF0000XFamily Nurse Practitioner201466NC
2363LP0808XPsychiatric/Mental Health Nurse Practitioner201466NC

General Provider Information

NPI Number : 1528171139
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORINDA LEWIS DEW FNP
Provider Business Mailing Address
First Line : 1044 KADER MERRITT RD
Second Line :
City : ROSE HILL
State : NC
Zip : 28458-8678
Country : US
Telephone Number : 910-532-2442
Fax Number :
Provider Business Practice Location Address
First Line : 200 TARPON TRL
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-5287
Country : US
Telephone Number : 910-346-5944
Fax Number : 910-296-2139
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 06/13/2013

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Directions to “ DORINDA LEWIS DEW FNP” Practice Location

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