Provider Demographics
NPI:1013044205
Name:LEWIS, JUNE (RN)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MARCELLA FALLS RD
Mailing Address - Street 2:
Mailing Address - City:ETHRIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:38456-5031
Mailing Address - Country:US
Mailing Address - Phone:931-829-5235
Mailing Address - Fax:
Practice Address - Street 1:100 BLYTHEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4828
Practice Address - Country:US
Practice Address - Phone:931-388-5757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000094515163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse