Provider Demographics
NPI:1669862868
Name:LYONS, JAMI MARIE (DNP, APNP)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:MARIE
Last Name:LYONS
Suffix:
Gender:F
Credentials:DNP, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 W RESEARCH DR
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3452
Mailing Address - Country:US
Mailing Address - Phone:608-386-1358
Mailing Address - Fax:
Practice Address - Street 1:234 CASHMAN DR
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-3543
Practice Address - Country:US
Practice Address - Phone:715-861-1058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6205-33363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care