Provider Demographics
NPI:1851939409
Name:LEWIS, ISABELLE KATHLEEN (ACT, LAT)
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:KATHLEEN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:ACT, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10918 WEBER ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68142-1565
Mailing Address - Country:US
Mailing Address - Phone:402-881-2743
Mailing Address - Fax:
Practice Address - Street 1:5616 L ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68117-1333
Practice Address - Country:US
Practice Address - Phone:402-881-2743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer