Healthcare Provider Details

I. General information

NPI: 1598689572
Provider Name (Legal Business Name): JANNA LYONS RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 HOWARD ST
BOONE NC
28608-0020
US

IV. Provider business mailing address

PO BOX 32130
BOONE NC
28608-2130
US

V. Phone/Fax

Practice location:
  • Phone: 828-262-3148
  • Fax:
Mailing address:
  • Phone: 828-262-3148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL002335
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: