Provider Demographics
NPI:1245568674
Name:LEWIN, EDNA M (RN, MSN)
Entity Type:Individual
Prefix:MRS
First Name:EDNA
Middle Name:M
Last Name:LEWIN
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7215 LA GRANADA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-4136
Mailing Address - Country:US
Mailing Address - Phone:281-575-0526
Mailing Address - Fax:281-575-0057
Practice Address - Street 1:7215 LA GRANADA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-4136
Practice Address - Country:US
Practice Address - Phone:281-575-0526
Practice Address - Fax:281-575-0057
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X, 251E00000X, 372500000X, 372600000X, 374U00000X, 376J00000X, 376K00000X, 225100000X, 225X00000X
TX004177251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX025079701Medicaid
TX025079701Medicaid