Provider Demographics
NPI:1083244974
Name:LYLE, LANA (MHSC)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:LYLE
Suffix:
Gender:F
Credentials:MHSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15917 KINSACK RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16404-5243
Mailing Address - Country:US
Mailing Address - Phone:814-547-3460
Mailing Address - Fax:
Practice Address - Street 1:15917 KINSACK RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:16404-5243
Practice Address - Country:US
Practice Address - Phone:814-547-3460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA197311246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty