Lewellen, Kevin A

Lewellen, Kevin A is an sole proprietor health care provider with primary practice located at Corner Of Route N12 And N7 , Fort Defiance AZ 86504. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Lewellen, Kevin A can be contacted via phone (928) 729-8000.

Contact Information

Primary practice address
Corner Of Route N12 And N7 Fort Defiance AZ 86504
Phone: (928) 729-8000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APN11125 Tennessee

Profile Details

NPI number 1124047949
LBN Legal business name Lewellen, Kevin A
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2006
Last updated May 22nd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124047949 NPPES
Tennessee MEDICAID 3626474
Tennessee Other 4024090
Tennessee Other 430066708

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