Healthcare Provider Details

I. General information

NPI: 1487901435
Provider Name (Legal Business Name): DAWN MARIE LYONS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS DAWN ALGER

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13101 ALLEN RD
SOUTHGATE MI
48195-2216
US

IV. Provider business mailing address

2988 MIDDLEFIELD DR
TRENTON MI
48183-3541
US

V. Phone/Fax

Practice location:
  • Phone: 734-785-7700
  • Fax:
Mailing address:
  • Phone: 734-675-3151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704233764
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: