Provider Demographics
NPI:1295792232
Name:LYON, CLAUDIA MARIE (CRNA)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:MARIE
Last Name:LYON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-446-5238
Mailing Address - Fax:740-441-8058
Practice Address - Street 1:90 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1560
Practice Address - Country:US
Practice Address - Phone:740-446-5238
Practice Address - Fax:740-441-8058
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.00585-NA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0975824OtherMOLINA MEDICAID
OH0975824Medicaid
000000007007OtherANTHEM BCBS
WV5710034000Medicaid
001714072OtherMOUNTAIN STATE BCBS
430028925OtherRR MEDICARE
OH0975824Medicaid
R74012Medicare UPIN