Provider Demographics
NPI:1861058141
Name:LEWIS, SONYA MARIE (NP-C)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:MARIE
Last Name:LEWIS
Suffix:
Gender:
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:PO BOX 749306
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9306
Mailing Address - Country:US
Mailing Address - Phone:803-359-5533
Mailing Address - Fax:803-359-0127
Practice Address - Street 1:815 HIGHWAY 378
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-8316
Practice Address - Country:US
Practice Address - Phone:803-359-5533
Practice Address - Fax:803-359-0127
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22417363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health