Provider Demographics
NPI:1659968485
Name:LEWIS, PAULA COLETTE (RN/RNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:COLETTE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RN/RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 HARPER CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455-8211
Mailing Address - Country:US
Mailing Address - Phone:501-658-8996
Mailing Address - Fax:
Practice Address - Street 1:1875 HARPER CEMETERY RD
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-8211
Practice Address - Country:US
Practice Address - Phone:501-658-8996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR33000163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse