Basic Information
| Provider Information | |||||||||
| NPI: | 1629295993 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEWIS | ||||||||
| FirstName: | ISABELL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 302 TUDOR DR | ||||||||
| Address2: | |||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226034245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5407226296 | ||||||||
| FaxNumber: | 7777777777 | ||||||||
| Practice Location | |||||||||
| Address1: | 2250 HICKORY RD | ||||||||
| Address2: | SUITE#240 | ||||||||
| City: | PLYMOUTH MEETING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194621047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107503474 | ||||||||
| FaxNumber: | 4107503478 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 0002061010 | VA | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.