Provider Demographics
NPI:1104607191
Name:LEWIS, NATASHA RENEE (MSN, FNP)
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:RENEE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:RENEE
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 ROSARIO DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-8421
Mailing Address - Country:US
Mailing Address - Phone:843-670-7367
Mailing Address - Fax:
Practice Address - Street 1:86 JONATHAN LUCAS ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8900
Practice Address - Country:US
Practice Address - Phone:843-792-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27544363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily