Provider Demographics
NPI:1477792372
Name:LEWIS, MORRIS LEONARD (RN)
Entity Type:Individual
Prefix:MR
First Name:MORRIS
Middle Name:LEONARD
Last Name:LEWIS
Suffix:
Gender:M
Credentials:RN
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Mailing Address - Street 1:2550 UNIVERSITY AVE W STE 229N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1902
Mailing Address - Country:US
Mailing Address - Phone:651-645-3115
Mailing Address - Fax:651-645-2752
Practice Address - Street 1:2550 UNIVERSITY AVE W STE 229N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114
Practice Address - Country:US
Practice Address - Phone:651-645-3115
Practice Address - Fax:651-645-2752
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR133319-0364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health