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NPI Code Detail

MEDICARE: CLAUDENE LEWIS

MEDICARE: CLAUDENE LEWIS
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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1720611049
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAUDENE LEWIS
Provider Business Mailing Address
First Line : 3305 SPRING MOUNTAIN RD STE 107
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-8628
Country : US
Telephone Number : 702-487-5480
Fax Number :
Provider Business Practice Location Address
First Line : 3305 SPRING MOUNTAIN RD STE 107
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-8628
Country : US
Telephone Number : 702-487-5480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2020
Last Update Date : 02/14/2020

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Directions to “ CLAUDENE LEWIS ” Practice Location

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