Provider Demographics
NPI:1669643565
Name:LYTLE, CYNTHIA LEE (LPN)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LEE
Last Name:LYTLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 WORTHINGTON FOREST PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-4183
Mailing Address - Country:US
Mailing Address - Phone:614-985-3034
Mailing Address - Fax:
Practice Address - Street 1:601 WORTHINGTON FOREST PL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-4183
Practice Address - Country:US
Practice Address - Phone:614-985-3034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN102921164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse