Provider Demographics
NPI:1366253809
Name:LEWIS, AMETHYST JADE (RN)
Entity type:Individual
Prefix:MRS
First Name:AMETHYST
Middle Name:JADE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2922 UPPER HIGHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-0929
Mailing Address - Country:US
Mailing Address - Phone:406-696-6863
Mailing Address - Fax:
Practice Address - Street 1:2922 UPPER HIGHWOOD DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-0929
Practice Address - Country:US
Practice Address - Phone:406-696-6863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-130547163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical