Provider Demographics
NPI:1437600244
Name:LYLES, MARLENE RACHELLE
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:RACHELLE
Last Name:LYLES
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 1:840 BECKFORD ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-4471
Mailing Address - Country:US
Mailing Address - Phone:724-923-1057
Mailing Address - Fax:
Practice Address - Street 1:840 BECKFORD ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-4471
Practice Address - Country:US
Practice Address - Phone:724-923-1057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide