Provider Demographics
NPI:1699499830
Name:LEWIS, KATELIN JO (CNM, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:KATELIN
Middle Name:JO
Last Name:LEWIS
Suffix:
Gender:
Credentials:CNM, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 505
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2131
Mailing Address - Country:US
Mailing Address - Phone:615-340-4655
Mailing Address - Fax:615-340-4596
Practice Address - Street 1:300 20TH AVE N STE 505
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2131
Practice Address - Country:US
Practice Address - Phone:615-340-4655
Practice Address - Fax:615-340-4596
Is Sole Proprietor?:No
Enumeration Date:2022-09-30
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32653363LF0000X
TNCNM09880367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily