Provider Demographics
NPI:1821339557
Name:LEWIS, AMEENAH (LVN)
Entity Type:Individual
Prefix:MS
First Name:AMEENAH
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W PLEASANT RUN RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-5402
Mailing Address - Country:US
Mailing Address - Phone:972-291-5977
Mailing Address - Fax:
Practice Address - Street 1:224 W PLEASANT RUN RD
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-5402
Practice Address - Country:US
Practice Address - Phone:972-291-5977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX176963164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse