Provider Demographics
NPI:1184973331
Name:LEWIS, MEREDITH (ARNP)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N HOGAN ST # 335
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-4201
Mailing Address - Country:US
Mailing Address - Phone:904-712-3380
Mailing Address - Fax:904-712-6210
Practice Address - Street 1:7317 STEVENTON WAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-8179
Practice Address - Country:US
Practice Address - Phone:904-712-3380
Practice Address - Fax:904-712-6210
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9246380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily