Provider Demographics
NPI:1740272665
Name:LYLES, ADRAINE NICOLE LAWRENCE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ADRAINE
Middle Name:NICOLE LAWRENCE
Last Name:LYLES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
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Mailing Address - Street 1:3013 DANRETT LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-7271
Mailing Address - Country:US
Mailing Address - Phone:804-795-1335
Mailing Address - Fax:804-628-1282
Practice Address - Street 1:401 N 12TH ST
Practice Address - Street 2:L-108
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5035
Practice Address - Country:US
Practice Address - Phone:804-628-0629
Practice Address - Fax:804-628-1282
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA02022057801835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy