Provider Demographics
NPI:1407221518
Name:LEWIS, DENA (DNP, APRN, AGACNP-BC)
Entity Type:Individual
Prefix:DR
First Name:DENA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DNP, APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19313 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CO
Mailing Address - Zip Code:81091-9742
Mailing Address - Country:US
Mailing Address - Phone:304-261-6204
Mailing Address - Fax:
Practice Address - Street 1:104 LEGION DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4804
Practice Address - Country:US
Practice Address - Phone:505-426-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0996448-NP363LA2100X
VA0024177427363LA2100X
WVAPRN67066-AGACNP-BC363LA2100X
NM61048363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care