Provider Demographics
NPI:1467174342
Name:LEWIS, CHRISTINA TAYLOR
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:TAYLOR
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 PLAIN VIEW HWY
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-7570
Mailing Address - Country:US
Mailing Address - Phone:919-763-4080
Mailing Address - Fax:
Practice Address - Street 1:1480 MAPLE GROVE CHURCH RD
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-7692
Practice Address - Country:US
Practice Address - Phone:910-567-6194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016920363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care