Individual provider · NPI-1
Enid D Lewis, RD
Dietitian, Registered · Espanola, NM
NPI number1215066766
StatusActive
Last updated in NPPESApr 20, 2010
Details
- NPI
- 1215066766
- Entity type
- Individual (NPI-1)
- Name
- Enid D Lewis
- Credential
- RD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 2, 2007
- Last updated
- Apr 20, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 525 | NM | Yes |
| 207Q00000X | Family Medicine | 525 | NM | |
| 133VN1005X | Dietitian, Registered, Nutrition, Renal | 525 | NM |
Practice location
1010 Spruce StEspanola Hospital
Espanola, NM 87532-2724
Phone 505-753-7111 · Fax 505-753-4438
Mailing address
Po Box 26666Phs Provider Enrollment
Albuquerque, NM 87125-6666
Phone 505-923-5356 · Fax 505-923-5654
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