Provider Demographics
NPI:1578321360
Name:LYMAN, KYLIE CLAIRE
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:CLAIRE
Last Name:LYMAN
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 1:32630 VALE ST NW
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-4503
Mailing Address - Country:US
Mailing Address - Phone:763-412-0440
Mailing Address - Fax:
Practice Address - Street 1:101 7TH ST SW
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1996
Practice Address - Country:US
Practice Address - Phone:712-707-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant