Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 0024176020 | VA |
N | 363LA2100X | Nurse Practitioner - Acute Care | RN1023367 | DC |
NPI | 1043733041 |
---|---|
Provider Name | Mrs. Cameron Nichole Lewis |
First Address | Arlington, VA 22204-3913 |
Second Address | Alexandria, VA 22303-1868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2017 |
Last Update Date | 10/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0024176020 | VA- NURSE PRACTITIONER LICENSE (01) | VA |