Healthcare Provider Details

I. General information

NPI: 1073950002
Provider Name (Legal Business Name): JEAN COZAD LYON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2013
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 COLLEGE PKWY SUITE 130
CARSON CITY NV
89706-8022
US

IV. Provider business mailing address

45 SUNRIDGE DR
RENO NV
89511-8727
US

V. Phone/Fax

Practice location:
  • Phone: 775-885-6940
  • Fax:
Mailing address:
  • Phone: 775-771-0346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN 0277
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: