Provider Demographics
NPI:1215790068
Name:LEWIS, VANESSA RENAY (MSN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:RENAY
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MSN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100181
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3141
Mailing Address - Country:US
Mailing Address - Phone:828-202-5200
Mailing Address - Fax:
Practice Address - Street 1:4226 E US HIGHWAY 64-ALT
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6966
Practice Address - Country:US
Practice Address - Phone:828-479-6434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019584363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health