Provider Demographics
NPI:1831640879
Name:LEWIS, JOSEPH (APRN)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:LEWIS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10510 LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-1228
Mailing Address - Country:US
Mailing Address - Phone:502-253-7060
Mailing Address - Fax:502-253-7049
Practice Address - Street 1:10510 LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-1228
Practice Address - Country:US
Practice Address - Phone:502-253-7060
Practice Address - Fax:502-253-7049
Is Sole Proprietor?:No
Enumeration Date:2016-10-14
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006586A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily