Provider Demographics
NPI:1508365230
Name:LEWIS, ALYSON ELIZABETH (PA-C, ATC)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:ELIZABETH
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PA-C, ATC
Other - Prefix:
Other - First Name:ALYSON
Other - Middle Name:ELIZABETH
Other - Last Name:EWIGMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:135 OLD GRAY STATION RD APT 317
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-3457
Mailing Address - Country:US
Mailing Address - Phone:606-594-9490
Mailing Address - Fax:
Practice Address - Street 1:135 OLD GRAY STATION RD APT 317
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37615-3457
Practice Address - Country:US
Practice Address - Phone:606-594-9490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer