MEDICARE: MS. KAREN RENEE 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	237700000X	Hearing Instrument Specialist	HADS000673	GA

General Provider Information

NPI Number	:	1770869778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN RENEE LEWIS

Provider Business Mailing Address
First Line	:	PO BOX 450264
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31145-0264
Country	:	US
Telephone Number	:	770-363-6637
Fax Number	:	770-814-9772

Provider Business Practice Location Address
First Line	:	2114 HENDERSON MILL RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-3762
Country	:	US
Telephone Number	:	770-363-6637
Fax Number	:	770-814-9772

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

Provider Enumeration Date	:	10/24/2011
Last Update Date	:	10/24/2011

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