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NPI Code Detail

MEDICARE: SHANNON FAYE LEWIS LPN

MEDICARE: SHANNON FAYE LEWIS LPN
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
1164W00000XLicensed Practical Nurse2047469KY

General Provider Information

NPI Number : 1811552060
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON FAYE LEWIS LPN
Provider Business Mailing Address
First Line : 213 MIDLAND BLVD
Second Line :
City : SHELBYVILLE
State : KY
Zip : 40065-7791
Country : US
Telephone Number : 502-647-0154
Fax Number : 502-633-4043
Provider Business Practice Location Address
First Line : 213 MIDLAND BLVD
Second Line :
City : SHELBYVILLE
State : KY
Zip : 40065-7791
Country : US
Telephone Number : 502-647-0154
Fax Number : 502-633-4043
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2019
Last Update Date : 05/03/2019

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Directions to “ SHANNON FAYE LEWIS LPN” Practice Location

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