=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467309278
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LYTRICE NASHAY ATKINS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2026
-----------------------------------------------------
Last Update Date | 03/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 821 E MAIN ST APT H01
-----------------------------------------------------
City | RIVERHEAD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11901-2502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 934-500-3697
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 821 E MAIN ST APT H01
-----------------------------------------------------
City | RIVERHEAD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11901-2502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 934-500-3697
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164W00000X
-----------------------------------------------------
Taxonomy Name | Licensed Practical Nurse
-----------------------------------------------------
License Number | 347227-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------