Doctor Name: | JESSICA MARIE LYONS |
NPI Number: | 1285009555 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N.,F.N.P.-C |
License Number: | RN169668 |
Business Practice Address: | 361 Cargile Road Ocilla, GA - 31774 |
Business Phone Number: | 2294689903 |
Business Fax Number: | 2294685417 |
Mailing Address: | 361 Cargile Road, OCILLA |
State: | GA |
Postal Code: | 31774 |
Phone Number: | 2294689903 |
Fax Number: | 2294685417 |
NPI Enumeration Date: | 12/11/2015 |
NPI Last Update Date: | 01/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN169668 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |