| NPI | 1629317045 |
|---|---|
| Former Name | AMANDA BROOKE LEWIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18141) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006071) |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2022-02-23 |