Provider Demographics
NPI:1689670663
Name:LEWIS, BUNNY DAY (CNM, NP)
Entity Type:Individual
Prefix:MS
First Name:BUNNY
Middle Name:DAY
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CNM, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1284 ORCHID ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-7326
Mailing Address - Country:US
Mailing Address - Phone:541-488-2925
Mailing Address - Fax:541-306-6620
Practice Address - Street 1:540 CATALINA DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1605
Practice Address - Country:US
Practice Address - Phone:541-488-2925
Practice Address - Fax:541-482-7673
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2007-08-13
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
OR091006559N5363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR135322Medicaid
ORR119086Medicare ID - Type UnspecifiedGROUP NUMBER
OR135322Medicaid