Basic Information
| Provider Information | |||||||||
| NPI: | 1003147513 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNETT-LEWIS | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | |||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 238 N MARQUETTE ST | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537045150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082450693 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 238 N MARQUETTE ST | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537045150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082450693 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2010 | ||||||||
| LastUpdateDate: | 01/22/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 112288-030 | WI | Y | Nursing Service Providers | Registered Nurse | 163WC0400X | 112288-030 | WI | N | Nursing Service Providers | Registered Nurse | Case Management |
No ID Information.