Provider Demographics
NPI:1568237618
Name:LEWIS, CHANDRA E (CBD-HVD)
Entity Type:Individual
Prefix:MS
First Name:CHANDRA
Middle Name:E
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CBD-HVD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6343 PHEASANT LN APT 65
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-2243
Mailing Address - Country:US
Mailing Address - Phone:608-200-4337
Mailing Address - Fax:
Practice Address - Street 1:6343 PHEASANT LN APT 65
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-2243
Practice Address - Country:US
Practice Address - Phone:608-200-4337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No174400000XOther Service ProvidersSpecialist
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No175T00000XOther Service ProvidersPeer Specialist