Provider Demographics
NPI:1598144297
Name:LEWIS, REBECCA (FNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 CALIFORNIA ST
Mailing Address - Street 2:STE A
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1953
Mailing Address - Country:US
Mailing Address - Phone:530-247-7070
Mailing Address - Fax:530-244-7246
Practice Address - Street 1:3270 CHURN CREEK RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2504
Practice Address - Country:US
Practice Address - Phone:530-222-3287
Practice Address - Fax:530-222-8547
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA687013363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily