Provider Demographics
NPI:1780494021
Name:LEWIS, MEGAN R (CNA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:R
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 REGENCY CIR APT 107
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-7865
Mailing Address - Country:US
Mailing Address - Phone:859-203-5972
Mailing Address - Fax:
Practice Address - Street 1:534 REGENCY CIR APT 107
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-7865
Practice Address - Country:US
Practice Address - Phone:859-203-5972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4023716376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide