Healthcare Provider Details

I. General information

NPI: 1083346233
Provider Name (Legal Business Name): LANA LYNN SYKES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 PRAIRIE AVE
CHEYENNE WY
82009-4867
US

IV. Provider business mailing address

2274 CARINA CT
CHEYENNE WY
82009-9735
US

V. Phone/Fax

Practice location:
  • Phone: 719-351-6698
  • Fax:
Mailing address:
  • Phone: 719-351-6698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number41786
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number50460
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: