Provider Demographics
NPI:1346259900
Name:LEWIS, JOHN H JR (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:H
Last Name:LEWIS
Suffix:JR
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7003 CHADWICK DRIVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027
Mailing Address - Country:US
Mailing Address - Phone:615-579-8933
Mailing Address - Fax:615-465-2237
Practice Address - Street 1:127 WALTERS AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2604
Practice Address - Country:US
Practice Address - Phone:615-579-8933
Practice Address - Fax:615-472-8119
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005254363LP0808X
TNRN0000038532163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3907993Medicaid