Provider Demographics
NPI:1114102043
Name:LYIONS, MELISSA C (CRNA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:C
Last Name:LYIONS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3355 GLENDALE AVE
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2426
Mailing Address - Country:US
Mailing Address - Phone:419-383-3556
Mailing Address - Fax:419-383-3550
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:FLOOR 2, ROOM 2195
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2595
Practice Address - Country:US
Practice Address - Phone:419-383-3556
Practice Address - Fax:419-383-3550
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN312359367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered