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AMANDA L LEWIS PA-C

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1801997226

Individual Registrant:
 AMANDA L LEWIS PA-C
Gender: F
Not Sole Proprietor

Location and contact information for practice:
103 CHICO CT  MONTE VISTA, CO 81144-1065 US
Tel: 719-852-9400  Fax: --

Contact information for business:
310 COUNTY ROAD 14  DEL NORTE, CO 81132-8719 US
Tel: 719-657-4102  Fax: 719-657-4106

Registration Information:
NPI: 1801997226
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
CO4185
N363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
AZ2181

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
851148AZ05




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