Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | R151871 | MD |
NPI | 1053355479 |
---|---|
Provider Name | Kristyn L Lyons |
First Address | Stevensville, MD 21666-2536 |
Second Address | Annapolis, MD 21403-1507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/07/2007 |