Provider Demographics
NPI:1114608882
Name:LYONS, JULIE RENEE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:RENEE
Last Name:LYONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 KAY ST # 2227
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-4642
Mailing Address - Country:US
Mailing Address - Phone:606-872-1284
Mailing Address - Fax:
Practice Address - Street 1:80 KAY ST # 2227
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-4642
Practice Address - Country:US
Practice Address - Phone:606-872-1284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist