Provider Demographics
NPI:1275160905
Name:LEWIS, KYLEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:16134-9117
Mailing Address - Country:US
Mailing Address - Phone:724-932-5355
Mailing Address - Fax:
Practice Address - Street 1:121 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:PA
Practice Address - Zip Code:16134-9117
Practice Address - Country:US
Practice Address - Phone:724-932-5355
Practice Address - Fax:724-932-3943
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032332631835P0018X
PARP448478111835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist