Provider Demographics
NPI:1447779772
Name:LEWIS, NATALIE NICOLE (MSN, CRNP, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:NICOLE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MSN, CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PEACH BLOSSOM RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-2544
Mailing Address - Country:US
Mailing Address - Phone:410-763-9635
Mailing Address - Fax:833-914-0415
Practice Address - Street 1:201 PEACH BLOSSOM RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-2547
Practice Address - Country:US
Practice Address - Phone:410-763-9635
Practice Address - Fax:833-914-0415
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201779363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily