Healthcare Provider Details

I. General information

NPI: 1386513190
Provider Name (Legal Business Name): LESLIE J LYONS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2868 DARLA DR
GRAND JUNCTION CO
81506-4820
US

IV. Provider business mailing address

2868 DARLA DR
GRAND JUNCTION CO
81506-4820
US

V. Phone/Fax

Practice location:
  • Phone: 970-560-9449
  • Fax:
Mailing address:
  • Phone: 970-560-9449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1002062-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: