Provider Demographics
NPI:1093038184
Name:LEWIS, SHARON ASHLEY (LPN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ASHLEY
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 KING BIRD LN
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-0825
Mailing Address - Country:US
Mailing Address - Phone:937-859-3761
Mailing Address - Fax:
Practice Address - Street 1:4231 KING BIRD LN
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-0825
Practice Address - Country:US
Practice Address - Phone:937-859-3761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN129135164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse