Provider Demographics
NPI:1740611664
Name:LEWIS, AMANDA (CNM)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31164 LA HIGHWAY 16 APT 302
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-9026
Mailing Address - Country:US
Mailing Address - Phone:225-503-9613
Mailing Address - Fax:
Practice Address - Street 1:2611 N DINUBA BLVD
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-9003
Practice Address - Country:US
Practice Address - Phone:559-623-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2025-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07562367A00000X
CA236598367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife