Provider Demographics
NPI:1134441702
Name:DEPUTY, LYRON ANDRE (CNS,FNP-BC)
Entity type:Individual
Prefix:MR
First Name:LYRON
Middle Name:ANDRE
Last Name:DEPUTY
Suffix:
Gender:M
Credentials:CNS,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 CHAPMAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5426
Mailing Address - Country:US
Mailing Address - Phone:302-652-5109
Mailing Address - Fax:877-575-3337
Practice Address - Street 1:261 CHAPMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5426
Practice Address - Country:US
Practice Address - Phone:302-652-5109
Practice Address - Fax:877-575-3337
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0001219363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner