Provider Demographics
NPI:1255000568
Name:LEWIS, AUBREY (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19354 DETROIT RD SPC A-108
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-1802
Mailing Address - Country:US
Mailing Address - Phone:440-595-0773
Mailing Address - Fax:
Practice Address - Street 1:19354 DETROIT RD
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-1802
Practice Address - Country:US
Practice Address - Phone:440-595-0773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP.0027866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily