Provider Demographics
NPI:1457834806
Name:LEWIS, BREEANN MICHELLE (RCSN)
Entity Type:Individual
Prefix:MRS
First Name:BREEANN
Middle Name:MICHELLE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RCSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E BUSH ST
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-3601
Mailing Address - Country:US
Mailing Address - Phone:559-924-6600
Mailing Address - Fax:559-924-5086
Practice Address - Street 1:101 E BUSH ST
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-3601
Practice Address - Country:US
Practice Address - Phone:559-924-6600
Practice Address - Fax:559-924-5086
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA813938163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool