Provider Demographics
NPI:1538615885
Name:LEWIS, LAUREN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-4166
Mailing Address - Country:US
Mailing Address - Phone:423-326-7047
Mailing Address - Fax:
Practice Address - Street 1:1425 S MOORE RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-2836
Practice Address - Country:US
Practice Address - Phone:423-508-8728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily