MEDICARE: PENELEPE LEWIS N.P.

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	363L00000X	Nurse Practitioner	3295	SC

General Provider Information

NPI Number	:	1548521180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PENELEPE LEWIS N.P.

Provider Business Mailing Address
First Line	:	507 W PALMETTO ST
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29501-4427
Country	:	US
Telephone Number	:	843-669-1010
Fax Number	:	843-669-7676

Provider Business Practice Location Address
First Line	:	507 W PALMETTO ST
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29501-4427
Country	:	US
Telephone Number	:	843-669-1010
Fax Number	:	843-669-7676

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

Provider Enumeration Date	:	05/30/2012
Last Update Date	:	04/20/2016

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Directions to “ PENELEPE LEWIS N.P.” Practice Location

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