Provider Demographics
NPI:1487353934
Name:LEWIS, LISA MICHELE (RN, CDCES)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MICHELE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12502 WILLOWBROOK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-6498
Mailing Address - Country:US
Mailing Address - Phone:240-964-8778
Mailing Address - Fax:240-964-8679
Practice Address - Street 1:12502 WILLOWBROOK RD STE 300
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-6498
Practice Address - Country:US
Practice Address - Phone:240-964-8778
Practice Address - Fax:240-964-8679
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator