Provider Demographics
NPI:1114560539
Name:JUNIOUS LYONS, MICHELE (FNP)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:
Last Name:JUNIOUS LYONS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 185TH ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-6508
Mailing Address - Country:US
Mailing Address - Phone:708-251-8327
Mailing Address - Fax:
Practice Address - Street 1:1631 185TH ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-6508
Practice Address - Country:US
Practice Address - Phone:708-251-8327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209020216363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily