Provider Demographics
NPI:1689358418
Name:LEWIS, JASMINE VIRGINIA (APRN)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:VIRGINIA
Last Name:LEWIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CHAMBER OF COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-4346
Mailing Address - Country:US
Mailing Address - Phone:469-442-4325
Mailing Address - Fax:
Practice Address - Street 1:108 CHAMBER OF COMMERCE DR
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-4346
Practice Address - Country:US
Practice Address - Phone:469-442-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF06230019363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily