Provider Demographics
NPI:1275261646
Name:LEWIS, DONNIECE LYNN
Entity Type:Individual
Prefix:
First Name:DONNIECE
Middle Name:LYNN
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 1:238 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26347-6390
Mailing Address - Country:US
Mailing Address - Phone:304-627-8354
Mailing Address - Fax:
Practice Address - Street 1:238 SMITH RD
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:WV
Practice Address - Zip Code:26347-6390
Practice Address - Country:US
Practice Address - Phone:304-627-8354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant