Provider Demographics
NPI:1881435535
Name:LEWIS, LORI ANNE (RN, PHN, CSN)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ANNE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RN, PHN, CSN
Other - Prefix:
Other - First Name:LORIANNE
Other - Middle Name:LEWIS
Other - Last Name:SCHAEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:901 MYRTLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1219
Mailing Address - Country:US
Mailing Address - Phone:707-445-7000
Mailing Address - Fax:707-445-7143
Practice Address - Street 1:901 MYRTLE AVENUE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1219
Practice Address - Country:US
Practice Address - Phone:707-445-7000
Practice Address - Fax:707-445-7143
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332421163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool