Healthcare Provider Details

I. General information

NPI: 1740674498
Provider Name (Legal Business Name): MEREDYTH LYONS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12351 PERRY HWY
WEXFORD PA
15090-8344
US

IV. Provider business mailing address

812 HURON CT
GIBSONIA PA
15044-8039
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-6581
  • Fax: 412-359-3483
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN636128
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number105721
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN636128
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: