Provider Demographics
NPI:1649390956
Name:LEWIS, BEVERLY LYNN (MASTER OF SCIENCE)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:LYNN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MASTER OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LEWIS HEARING SERVICES
Mailing Address - Street 2:407 A HWY. 79
Mailing Address - City:DOVER
Mailing Address - State:TN
Mailing Address - Zip Code:37058
Mailing Address - Country:US
Mailing Address - Phone:931-232-7112
Mailing Address - Fax:031-232-7113
Practice Address - Street 1:LEWIS HEARING SERVICES
Practice Address - Street 2:407 A HWY. 79
Practice Address - City:DOVER
Practice Address - State:TN
Practice Address - Zip Code:37058
Practice Address - Country:US
Practice Address - Phone:931-232-7112
Practice Address - Fax:031-232-7113
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1407231H00000X
KY0132231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3967140Medicaid
TN4119206OtherBLUE CROSS BLUE SHIELD
TN3967140Medicaid