Provider Demographics
NPI:1700221538
Name:LEWIS, DARCEE LYN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DARCEE
Middle Name:LYN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16527 STATE HIGHWAY 8
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NY
Mailing Address - Zip Code:13838-8659
Mailing Address - Country:US
Mailing Address - Phone:607-265-9965
Mailing Address - Fax:
Practice Address - Street 1:16527 STATE HIGHWAY 8
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NY
Practice Address - Zip Code:13838-8659
Practice Address - Country:US
Practice Address - Phone:607-265-9965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290417164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse