Individual ProviderDiane LewtonNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140(260) 432-2297PECOS EnrollmentBased on the most recent information from CMS, provider Diane Lewton does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1518926443Provider TypeIndividualFull NameLewton, DianeCredentialN.P.GenderFemaleSole ProprietorNoEnumeration Date3/20/2006Last Updated5/31/2011Contact InformationPractice LocationPractice Address7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140Phone(260) 432-2297Fax(260) 434-6420Mailing LocationMailing Address6920 Pointe Inverness Way, Ste 200, Fort Wayne, IN 46804-7934Phone(260) 432-2297Fax(260) 434-6420Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71000599IndianaProvider IdentifiersIDDescriptionIssuerID500016270DescriptionOtherIssuerRAILROADID2463892DescriptionMedicaidIssuerUnlistedOhioIDLENP15741DescriptionOtherIssuerMEDICAID-VANWERTOhioID200321230DescriptionMedicaidIssuerUnlistedIndianaIDLENP15742DescriptionOtherIssuerMEDICAID-PAULDINGOhioID000000291182DescriptionOtherIssuerANTHEMIndiana