Provider Demographics
NPI:1790557684
Name:CHRISTINA LEWIS APRN LLC
Entity Type:Organization
Organization Name:CHRISTINA LEWIS APRN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP APRN-RX FNP-C
Authorized Official - Phone:808-426-8085
Mailing Address - Street 1:2916 DATE ST APT 5A
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1185
Mailing Address - Country:US
Mailing Address - Phone:808-426-8085
Mailing Address - Fax:
Practice Address - Street 1:2916 DATE ST APT 5A
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1185
Practice Address - Country:US
Practice Address - Phone:808-426-8085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care