KRISTIN LEWIS STORES (NPI# 1083927073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083927073 |
| Entity Type | Individual |
| Full Name | KRISTIN LEWIS STORES |
| Other Name | KRISTIN MICHELE LEWIS |
| Credential | ARNP |
| Practice Address |
14546 Old Saint Augustine Rd Ste 103 Credentialing Department Jacksonville FL 32258-5469 |
| Mailing Address |
Po Box 43667 Credentialing Department Jacksonville FL 32203-3667 |
| Practice Telephone | 9043380855 |
| Practice Fax Number | 9043380852 |
| Mailing Telephone | 9043983760 |
| Mailing Fax Number | 9043380852 |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2015-11-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
ARNP9246928 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 002587400 | 05 | |
| FL | RR MEDICARE | P01070656 | 01 |
| Street Address |
14546 OLD SAINT AUGUSTINE RD STE 103 CREDENTIALING DEPARTMENT |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32258-5469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669696407 | Ruple Jayantilal Galani | Internal Medicine | 14546 Old Saint Augustine Rd Ste 103, Credentialing Department, Jacksonville, FL 32258-5469 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437794237 | Nicoleta Descalzo | Behavior Technician | 12724 Grand Bay Parkway West, Suite 410, Jacksonville, FL 32258 | 2019-11-15 |
| 1992275572 | William Lundgren | Nurse Anesthetist, Certified Registered | 3625 University Blvd South, Jacksonville, FL 32258 | 2018-11-27 |
| 1104301159 | Emergency Physicians Inc | Emergency Medicine | 14534 Old St Augustine Rd, Suite 3110, Jacksonville, FL 32258 | 2018-09-26 |
| 1679092886 | Palm Life Medical Associates Pa | Assisted Living Facility | 12494 Acosta Oaks Drive, Jacksonville, FL 32258 | 2017-09-19 |
| 1679013932 | Optometry Vision Care Pllc | Optometrist | 14866 Old St. Augustine Rd Unit 110, Jacksonville, FL 32258 | 2017-03-06 |
| 1467991950 | North Florida Vision Group Inc | Optometrist | 14866 Old St. Augustine Rd., Suite 110, Jacksonville, FL 32258 | 2017-02-16 |
| 1124576566 | Revolution Chiropractic LLC | Chiropractor | 14866 Old St Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-14 |
| 1396291936 | Robyn Reaves | Nurse Practitioner | 12361 Richards Glen Ct, Jacksonville, FL 32258 | 2016-09-01 |
| 1326595927 | Lauren Cost | Chiropractor | 14866 Old St. Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-01 |
| 1487991170 | Mark Steven Colosimo | Pharmacist | 13820 Old St Augustine Road, Jacksonville, FL 32258 | 2013-01-15 |
| Find all providers in zip 32258 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615440 | Bridget Mary Rossi | Nurse Practitioner | 1536 Alford Street, Unit 5, Jacksonville, FL 32207-3220 | 2020-10-08 |
| 1972119535 | Dennis Carmelo Cadiz Serfino | Nurse Practitioner | 1960 Willesdon Dr E, Jacksonville, FL 32246-0694 | 2020-09-18 |
| 1497368757 | Arthur C Ricker Jr. | Nurse Practitioner | 501 E Bay St Fl 32202, Jacksonville, FL 32202-2927 | 2020-08-26 |
| 1851851554 | Veronica H Bartley | Nurse Practitioner | 15319 Spotted Stallion Trl, Jacksonville, FL 32234-2397 | 2019-03-20 |
| 1366947475 | Tikilia Denise Scott | Nurse Practitioner | 3599 University Blvd S Ste 400, Jacksonville, FL 32216-4232 | 2018-03-29 |
| 1376065417 | Geraldine M Obi | Nurse Practitioner | 3599 University Blvd S Ste 1600, Jacksonville, FL 32216-7441 | 2017-07-11 |
| 1881130060 | Yaazmiyn White | Nurse Practitioner | 8868 Merseyside Ave, Jacksonville, FL 32219-4355 | 2017-01-12 |
| 1821545872 | Anmarie Chandler | Nurse Practitioner | 320 Branscomb Dr Sw Ste A, Jacksonville, AL 36265-3102 | 2016-09-07 |
| 1538523402 | Julia Peters Paul | Nurse Practitioner | 10898 Tarin Dr, Jacksonville, FL 32218-4808 | 2016-04-07 |
| 1487035465 | Aggie Kalyn Hunt | Nurse Practitioner | 237 Old White Street, Suite 1, Jacksonville, NC 28546-6351 | 2015-06-15 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32258 |
Please comment or provide details below to improve the information on KRISTIN LEWIS STORES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.