Provider Demographics
NPI:1417115072
Name:LYONS, PATSY ANN
Entity Type:Individual
Prefix:MS
First Name:PATSY
Middle Name:ANN
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:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-0697
Mailing Address - Country:US
Mailing Address - Phone:870-208-8974
Mailing Address - Fax:
Practice Address - Street 1:1028 POPLAR AVE W
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-1931
Practice Address - Country:US
Practice Address - Phone:870-208-8974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide