Denise Lewis, NP

Individual provider Active NPI Adult Health Nurse Practitioner · McCloud, CA

NPI 1992830228 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992830228
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Nurse Practitioner 363LA2200X
License
525260 (CA)
Practice address
116 W Minnesota Ave
McCloud, CA 96057
Phone
(530) 964-2389
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
525260CAMDAdult Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 525260 CA Yes

Addresses

Primary practice location

116 W Minnesota Ave
McCloud, CA 96057

Mailing address

2221 Center Rd
Novato, CA 94947-2056

Other providers in McCloud, CA

All providers in McCloud, CA · Adult Health Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.