Provider Demographics
NPI:1215301320
Name:LEW, SYBIL (NP)
Entity type:Individual
Prefix:
First Name:SYBIL
Middle Name:
Last Name:LEW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DELUXE CIR SUITE B
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-5156
Mailing Address - Country:US
Mailing Address - Phone:706-647-7509
Mailing Address - Fax:706-647-6624
Practice Address - Street 1:101 DELUXE CIR STE B
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-3030
Practice Address - Country:US
Practice Address - Phone:706-647-7509
Practice Address - Fax:706-647-6624
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN122239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily