Provider Demographics
NPI:1043994064
Name:LEWIS, RENADA YOUNG (DOULA)
Entity Type:Individual
Prefix:
First Name:RENADA
Middle Name:YOUNG
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 MANSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-5726
Mailing Address - Country:US
Mailing Address - Phone:804-332-3336
Mailing Address - Fax:804-320-1520
Practice Address - Street 1:705 TWINRIDGE LN STE 6
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5270
Practice Address - Country:US
Practice Address - Phone:804-320-1220
Practice Address - Fax:804-320-1520
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula