MEDICARE: MS. LORRAINE JODY-ANN 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
1	363L00000X	Nurse Practitioner	5024216	NC

General Provider Information

NPI Number	:	1720865306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORRAINE JODY-ANN LEWIS

Provider Business Mailing Address
First Line	:	410 COLLEGE RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-5151
Country	:	US
Telephone Number	:	336-218-0994
Fax Number	:	336-883-0867

Provider Business Practice Location Address
First Line	:	410 COLLEGE RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-5151
Country	:	US
Telephone Number	:	336-218-0994
Fax Number	:	336-883-0867

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

Provider Enumeration Date	:	09/08/2023
Last Update Date	:	06/08/2026

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