Provider Demographics
NPI:1134435878
Name:LYONS, KIANNA MICHELLE (NP)
Entity type:Individual
Prefix:
First Name:KIANNA
Middle Name:MICHELLE
Last Name:LYONS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:28963 LITTLE MACK AVE
Mailing Address - Street 2:101
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-3017
Mailing Address - Country:US
Mailing Address - Phone:586-447-0700
Mailing Address - Fax:586-498-0707
Practice Address - Street 1:28963 LITTLE MACK AVE
Practice Address - Street 2:101
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-3017
Practice Address - Country:US
Practice Address - Phone:586-447-0700
Practice Address - Fax:586-498-0707
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704249768363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care