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General NPI Number Information
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NPI Number | 1073197786
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Entity Type | Individual
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Provider Name | ERICA C LYDEN NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 05/09/2021
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 18 S 9TH ST STE 107
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City | STROUDSBURG
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State | PA
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Zip | 18360-1630
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Country | US
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Telephone | 570-213-9133
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Fax | 570-209-8806
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Provider Business Mailing Address
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Address Line | 18 S 9TH ST STE 107
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City | STROUDSBURG
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State | PA
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Zip | 18360-1630
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Country | US
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Telephone | 570-213-9133
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Fax | 570-209-8806
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP023455
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License Number State | PA
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