Provider Demographics
NPI:1538199278
Name:LEWIS, KIMBERLY KNAPP (NP)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:KNAPP
Last Name:LEWIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:500 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-8708
Mailing Address - Country:US
Mailing Address - Phone:770-962-5100
Mailing Address - Fax:770-962-2400
Practice Address - Street 1:500 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 290
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-8708
Practice Address - Country:US
Practice Address - Phone:770-962-5100
Practice Address - Fax:770-962-2400
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN149478363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health