Provider Demographics
NPI:1457730665
Name:LEWIS, CARINA (APRN)
Entity Type:Individual
Prefix:
First Name:CARINA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:812-926-3133
Mailing Address - Fax:812-926-1668
Practice Address - Street 1:204 BRIDGEWAY ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IN
Practice Address - Zip Code:47001-1334
Practice Address - Country:US
Practice Address - Phone:812-926-3133
Practice Address - Fax:812-926-1668
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2818411A363LF0000X
IN71005649A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily