Provider Demographics
NPI:1679371157
Name:LEWIS, JESSICA LEIGH (AHG)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEIGH
Last Name:LEWIS
Suffix:
Gender:
Credentials:AHG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3603 W STAGE COACH TRL
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-9598
Mailing Address - Country:US
Mailing Address - Phone:818-331-1121
Mailing Address - Fax:
Practice Address - Street 1:3603 W STAGE COACH TRL
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-9598
Practice Address - Country:US
Practice Address - Phone:818-331-1121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other