Provider Demographics
NPI:1346444239
Name:LEWIS-SPRUILL, CAROLYN ELAINE (MSN,APN,C)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:ELAINE
Last Name:LEWIS-SPRUILL
Suffix:
Gender:F
Credentials:MSN,APN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-5815
Mailing Address - Country:US
Mailing Address - Phone:609-392-7789
Mailing Address - Fax:609-989-4245
Practice Address - Street 1:218 N BROAD ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08608-1306
Practice Address - Country:US
Practice Address - Phone:609-989-3332
Practice Address - Fax:609-989-4245
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN06070400363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health