Most Relevant Information
Provider Data
| NPI Number: | 1003467275 |
| Provider Name: | YANIQUE LATOYA LEWIS FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | RN248450 |
Most Important Dates
| Enumeration Date: | 09/27/2019 |
| Last Updated: | 01/18/2022 |
Provider Practice Location
1467 JOHN ROBERT DR STE B
MORROW
GA
302601770
Practice Location Phone/Fax
| Phone: | 7702938050 |
| Fax: |
Provider Mailing Location
1467 JOHN ROBERT DR STE B
MORROW
GA
302601770
Provider Mailing Phone/Fax
| Phone: | 7702938050 |
| Fax: |