Provider Demographics
NPI:1801823794
Name:LEWIS, LISA P (CNM)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:P
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SUNNYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1808
Mailing Address - Country:US
Mailing Address - Phone:919-250-4701
Mailing Address - Fax:336-322-6099
Practice Address - Street 1:10 SUNNYBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1808
Practice Address - Country:US
Practice Address - Phone:919-250-4701
Practice Address - Fax:919-250-4517
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCCNM-249367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife