Provider Demographics
NPI:1992946875
Name:BOESCH-LEWIS, SYLVIA D (FNP-BC)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:D
Last Name:BOESCH-LEWIS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 TUSCULUM BLVD STE 1200
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4341
Mailing Address - Country:US
Mailing Address - Phone:423-798-6630
Mailing Address - Fax:423-798-6633
Practice Address - Street 1:1406 TUSCULUM BLVD STE 4
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4332
Practice Address - Country:US
Practice Address - Phone:423-798-6630
Practice Address - Fax:423-798-6633
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14052363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4368756OtherBCBST
TN4358756OtherBLUECARE
TNQ001870Medicaid
TNP01237840OtherRAILROAD MEDICARE
TN4368756OtherBCBST