Provider Demographics
NPI:1982221305
Name:LYONS, REBECCA JEAN (RDN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEAN
Last Name:LYONS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3394 KY ROUTE 3385
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-8001
Mailing Address - Country:US
Mailing Address - Phone:606-434-6436
Mailing Address - Fax:
Practice Address - Street 1:3394 KY ROUTE 3385
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-8001
Practice Address - Country:US
Practice Address - Phone:606-434-6436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY240468133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered