Provider Demographics
NPI:1225880073
Name:LEWIS, ARTIA
Entity Type:Individual
Prefix:
First Name:ARTIA
Middle Name:
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 1:29120 DARDANELLA ST APT 6
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3534
Mailing Address - Country:US
Mailing Address - Phone:734-604-2819
Mailing Address - Fax:
Practice Address - Street 1:15075 LINCOLN ST APT 739
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1263
Practice Address - Country:US
Practice Address - Phone:734-604-2819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide