Provider Demographics
NPI:1578579991
Name:LEWIS, HILMA M (CFNP APRN)
Entity Type:Individual
Prefix:
First Name:HILMA
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CFNP APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 396
Mailing Address - Street 2:
Mailing Address - City:CUBA
Mailing Address - State:NM
Mailing Address - Zip Code:87013
Mailing Address - Country:US
Mailing Address - Phone:505-289-3291
Mailing Address - Fax:505-289-5101
Practice Address - Street 1:6349 MAIN STREET
Practice Address - Street 2:PMS CUBA HEALTH CENTER CHECKERBOARD AREA HEALTH SERVIC
Practice Address - City:CUBA
Practice Address - State:NM
Practice Address - Zip Code:87013
Practice Address - Country:US
Practice Address - Phone:505-289-3291
Practice Address - Fax:505-289-9101
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR35426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMZ4196Medicaid
NMZ4196Medicaid