Healthcare Provider Details

I. General information

NPI: 1962345470
Provider Name (Legal Business Name): ANGEL LYONS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 WEATHERVANE LN APT 3D
AKRON OH
44313-7902
US

IV. Provider business mailing address

1322 WEATHERVANE LN APT 3D
AKRON OH
44313-7902
US

V. Phone/Fax

Practice location:
  • Phone: 330-571-0977
  • Fax:
Mailing address:
  • Phone: 330-571-0977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: