Provider Demographics
NPI:1437707288
Name:LEWIS-BRENTLEY, TONYA (CNP)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:LEWIS-BRENTLEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24270 HARTLAND DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-2208
Mailing Address - Country:US
Mailing Address - Phone:216-315-0550
Mailing Address - Fax:
Practice Address - Street 1:5195 MAYFIELD RD # 102
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2464
Practice Address - Country:US
Practice Address - Phone:440-449-1014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024750363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily