Provider Demographics
NPI:1942218904
Name:LEWIS, KARLA KAYANN (RN LMT)
Entity type:Individual
Prefix:MS
First Name:KARLA
Middle Name:KAYANN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RN LMT
Other - Prefix:
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Mailing Address - Street 1:903 SOUTH KENDALL ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-5441
Mailing Address - Country:US
Mailing Address - Phone:630-740-8799
Mailing Address - Fax:
Practice Address - Street 1:903 SOUTH KENDALL ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-5441
Practice Address - Country:US
Practice Address - Phone:630-740-8799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163WM1400X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist