Provider Demographics
NPI:1376815209
Name:LEWIS, UMEKA LATASHA
Entity type:Individual
Prefix:MS
First Name:UMEKA
Middle Name:LATASHA
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 1/2 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-5031
Mailing Address - Country:US
Mailing Address - Phone:702-283-7691
Mailing Address - Fax:
Practice Address - Street 1:1308 1/2 JACKSON ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001
Practice Address - Country:US
Practice Address - Phone:702-283-7691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA372600000X372600000X
IA3747A0650X3747A0650X
IA3747P1801X3747P1801X
IA374U00000X374U00000X
IA376J00000X376J00000X
IA376K00000X376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide