Provider Demographics
NPI:1366483927
Name:LEWIS, VALERIE DENISE (RN)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:DENISE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:DENISE
Other - Last Name:CARSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1290 GOLFVIEW AVE
Mailing Address - Street 2:ATTN: BILLING DEPARTMENT
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-6738
Mailing Address - Country:US
Mailing Address - Phone:863-519-7900
Mailing Address - Fax:863-519-7696
Practice Address - Street 1:1805 HOBBS RD
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823-4644
Practice Address - Country:US
Practice Address - Phone:863-965-5400
Practice Address - Fax:863-965-3739
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9217213163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool