Provider Demographics
NPI:1841745452
Name:STUBBS, LEWIS JR (RN)
Entity Type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:
Last Name:STUBBS
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7208 MEADOWWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062-9166
Mailing Address - Country:US
Mailing Address - Phone:615-426-5503
Mailing Address - Fax:
Practice Address - Street 1:2629 FAIRVIEW BLVD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TN
Practice Address - Zip Code:37062-9084
Practice Address - Country:US
Practice Address - Phone:615-799-2389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN150000163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse