Provider Demographics
NPI:1174253355
Name:LEWKOVICH, KRISTEN (RN)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:LEWKOVICH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CONNECTICUT AVE NW APT 512
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-6118
Mailing Address - Country:US
Mailing Address - Phone:703-888-6698
Mailing Address - Fax:
Practice Address - Street 1:2000 CONNECTICUT AVE NW APT 512
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-6118
Practice Address - Country:US
Practice Address - Phone:703-888-6698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-12
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR253121163W00000X
NY769229163W00000X
DCRN200005292163WC0200X
VA0001274032163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse