Provider Demographics
NPI:1912901612
Name:LEWIS, KAREN MELISSA (FNP C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MELISSA
Last Name:LEWIS
Suffix:
Gender:F
Credentials:FNP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 63314
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3314
Mailing Address - Country:US
Mailing Address - Phone:828-696-1312
Mailing Address - Fax:828-696-1314
Practice Address - Street 1:1409 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-9524
Practice Address - Country:US
Practice Address - Phone:828-435-8400
Practice Address - Fax:828-435-8401
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23824363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004071Medicaid
NC7000997Medicaid
NC7004071Medicaid
NC2592033Medicare ID - Type Unspecified