LAJARVIS ANTWON LEWIS

RULEVILLE, MS
NPI1487271201
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  903985)
Enumeration Date2020-06-26
Last Update Date2020-06-26
Business Address
LAJARVIS ANTWON LEWIS FNP
840 N OAK AVE
RULEVILLE, MS 38771-3227
Phone number: 662-756-4024
Mailing Address
LAJARVIS ANTWON LEWIS FNP
PO BOX 4187
CLEVELAND, MS 38732-5287
Phone number: 662-719-9414