Provider Demographics
NPI:1194851543
Name:LEWIS, NANCY K
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:K
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 CAMPUS
Mailing Address - Street 2:KIDS KAMPUS
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750
Mailing Address - Country:US
Mailing Address - Phone:260-356-0123
Mailing Address - Fax:
Practice Address - Street 1:435 CAMPUS
Practice Address - Street 2:KIDS KAMPUS
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750
Practice Address - Country:US
Practice Address - Phone:260-356-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000700A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist