Provider Demographics
NPI:1043797095
Name:LEWIS, ASHLEY MARIE (CPNP-PC, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CPNP-PC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SAINT ANDREWS CT
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-6764
Mailing Address - Country:US
Mailing Address - Phone:912-267-0774
Mailing Address - Fax:
Practice Address - Street 1:300 COMMERCIAL CT UNIT F
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-7436
Practice Address - Country:US
Practice Address - Phone:912-744-0885
Practice Address - Fax:912-216-3297
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS9027312080P0006X, 363LP0200X
GA218481363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS902731OtherMISSISSIPPI BOARD OF NURSING