Provider Demographics
NPI:1225698533
Name:LEWIS, DANIELLE A (CMII)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:A
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CMII
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CMII
Mailing Address - Street 1:7170 S BRADEN AVE STE 195
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-6324
Mailing Address - Country:US
Mailing Address - Phone:918-280-0090
Mailing Address - Fax:
Practice Address - Street 1:6440 S LEWIS AVE STE 2200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1060
Practice Address - Country:US
Practice Address - Phone:918-712-0859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator