Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | RN260411 | GA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN260411 | GA |
NPI | 1033763479 |
---|---|
Provider Name | Lauren R Lewis |
First Address | Atlanta, GA 30368-3734 |
Second Address | Atlanta, GA 30309-1721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2019 |
Last Update Date | 08/07/2020 |