Provider Demographics
NPI:1750474904
Name:LEWIS, CATHERINE CELESTE (FNP)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:CELESTE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:4303 VICTORY DR 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7507
Mailing Address - Country:US
Mailing Address - Phone:512-462-3627
Mailing Address - Fax:512-462-3431
Practice Address - Street 1:2802 WEBBERVILLE RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2947
Practice Address - Country:US
Practice Address - Phone:512-978-9400
Practice Address - Fax:512-901-9726
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP115799363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185337602Medicaid
TX185337601Medicaid
UT296428YKYCMedicare PIN
TX8J6559Medicare PIN