Individual provider · NPI-1

Terry Lewis II, LPN

Home Health Aide · Lithonia, GA

NPI number1689287682

StatusActive

Last updated in NPPESAug 28, 2020

Details

NPI: 1689287682
Entity type: Individual (NPI-1)
Name: Mr. Terry Lewis II
Credential: LPN
Sex: Male
Sole proprietor: No
Enumeration date: Aug 28, 2020
Certification date: Aug 28, 2020
Last updated: Aug 28, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
374U00000X	Home Health Aide	–	–	Yes
104100000X	Social Worker	–	–
164W00000X	Licensed Practical Nurse	LPN090245	GA
172V00000X	Community Health Worker	–	–
372600000X	Adult Companion	–	–

Practice location

4935 River Overlook Way
Lithonia, GA 30038-6237

Phone 404-462-1233

Mailing address

4935 River Overlook Way
Lithonia, GA 30038-6237

Phone 404-462-1233

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