MEDICARE: ELISABETH ROSE LYONS ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	0197859	CO
2	163W00000X	Registered Nurse	118964	IA
3	363LW0102X	Women's Health Nurse Practitioner	F118964	IA

General Provider Information

NPI Number	:	1326565045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISABETH ROSE LYONS ARNP

Provider Business Mailing Address
First Line	:	1000 E ARMY POST RD
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50315-5939
Country	:	US
Telephone Number	:	515-285-6200
Fax Number	:	515-287-0204

Provider Business Practice Location Address
First Line	:	1000 E ARMY POST RD
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50315-5939
Country	:	US
Telephone Number	:	877-811-7526
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2017
Last Update Date	:	03/19/2019

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