Provider Demographics
NPI:1497916258
Name:LEWIS, KAREN L (LPN)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:L
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8658 CANYON COVE RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-9449
Mailing Address - Country:US
Mailing Address - Phone:614-870-5224
Mailing Address - Fax:614-870-5224
Practice Address - Street 1:8658 CANYON COVE RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-9449
Practice Address - Country:US
Practice Address - Phone:614-870-5224
Practice Address - Fax:614-870-5224
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 096189164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse