Provider Demographics
NPI:1811597750
Name:LYONS, KATHY LYNNE (RPH)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:LYNNE
Last Name:LYONS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 S US HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-9424
Mailing Address - Country:US
Mailing Address - Phone:765-362-5971
Mailing Address - Fax:765-362-3095
Practice Address - Street 1:1835 S US HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-9424
Practice Address - Country:US
Practice Address - Phone:765-362-5971
Practice Address - Fax:765-362-3095
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26012628A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist