Provider Demographics
NPI:1053364398
Name:LEWIS, QUIANA TAMIL (RN)
Entity type:Individual
Prefix:MISS
First Name:QUIANA
Middle Name:TAMIL
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5212
Mailing Address - Country:US
Mailing Address - Phone:805-347-8744
Mailing Address - Fax:
Practice Address - Street 1:90 VIA JUANA RD
Practice Address - Street 2:
Practice Address - City:SANTA YNEZ
Practice Address - State:CA
Practice Address - Zip Code:93460-9679
Practice Address - Country:US
Practice Address - Phone:805-688-7070
Practice Address - Fax:805-686-5321
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA643370163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse