Provider Demographics
NPI:1366321689
Name:LEWIS - SHAW, GIOVANNA
Entity type:Individual
Prefix:
First Name:GIOVANNA
Middle Name:
Last Name:LEWIS - SHAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7619 LOUISE CT
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2511
Mailing Address - Country:US
Mailing Address - Phone:313-815-9495
Mailing Address - Fax:313-815-9495
Practice Address - Street 1:7619 LOUISE CT
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-2511
Practice Address - Country:US
Practice Address - Phone:313-815-9495
Practice Address - Fax:313-815-9495
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-29
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health