Provider Demographics
NPI:1114019668
Name:LYONS, SHARON RUTH (CNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:RUTH
Last Name:LYONS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:859 GLADDEN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3812
Mailing Address - Country:US
Mailing Address - Phone:614-291-8990
Mailing Address - Fax:614-486-8304
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-5253
Practice Address - Fax:216-445-2806
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP08910363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNP08910OtherNP LICENSE
OHRN302904OtherRN LICENSE