Provider Demographics
NPI:1467855189
Name:LEWIS, MICHELLE LEWIS
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEWIS
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 1:7948 JILL LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-3820
Mailing Address - Country:US
Mailing Address - Phone:513-284-8745
Mailing Address - Fax:
Practice Address - Street 1:7948 JILL LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-3820
Practice Address - Country:US
Practice Address - Phone:513-284-8745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide