Provider Demographics
NPI:1669597662
Name:EVANS-LEWIS, JOANNE M (MSN WHNP)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:M
Last Name:EVANS-LEWIS
Suffix:
Gender:F
Credentials:MSN WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7236 JORDAN DR
Mailing Address - Street 2:STE 100A
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-8740
Mailing Address - Country:US
Mailing Address - Phone:605-718-3747
Mailing Address - Fax:605-718-3047
Practice Address - Street 1:7236 JORDAN DR
Practice Address - Street 2:SUITE 100 A
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-8740
Practice Address - Country:US
Practice Address - Phone:605-718-3747
Practice Address - Fax:605-718-3047
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SDCP000655363L00000X, 363LX0001X, 364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86N571Medicare ID - Type UnspecifiedPART B