Provider Demographics
NPI:1093812463
Name:LEWIS, LINDA D (RN, CS)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:D
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RN, CS
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:D
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:SWCMHC, PO BOX 1946
Mailing Address - Street 2:215 N. MAGNOLIA ST.
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29151-1946
Mailing Address - Country:US
Mailing Address - Phone:803-775-9364
Mailing Address - Fax:803-773-6615
Practice Address - Street 1:SWCMHC
Practice Address - Street 2:215 N. MAGNOLIA ST.
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29151-1946
Practice Address - Country:US
Practice Address - Phone:803-775-9364
Practice Address - Fax:803-773-6615
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19439163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health