Provider Demographics
NPI:1184324949
Name:LEWIS, JENNIFER LYNN (APRN, FNP-C)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:LYNN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6176 TIGER TRACE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-4631
Mailing Address - Country:US
Mailing Address - Phone:225-439-9425
Mailing Address - Fax:
Practice Address - Street 1:15389 AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-7312
Practice Address - Country:US
Practice Address - Phone:225-753-7233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA227323363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily