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NPI Code Detail

MEDICARE: HEIDI K LEWIS DNP, FNP-C

MEDICARE: HEIDI K LEWIS DNP, FNP-C
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
1363LC1500XCommunity Health Nurse Practitioner60607ID
2363LP0200XPediatric Nurse PractitionerAP60917566WA
3363LF0000XFamily Nurse Practitioner60607ID

General Provider Information

NPI Number : 1952874612
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI K LEWIS DNP, FNP-C
Provider Business Mailing Address
First Line : 6405 S 3000 E STE 300
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84121-6977
Country : US
Telephone Number : 801-266-3113
Fax Number : 801-266-5633
Provider Business Practice Location Address
First Line : 1525 ADDISON AVE E STE A2
Second Line :
City : TWIN FALLS
State : ID
Zip : 83301-5300
Country : US
Telephone Number : 228-739-9961
Fax Number : 208-739-9962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2019
Last Update Date : 01/14/2025

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