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General NPI Number Information
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NPI Number | 1669862868
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Entity Type | Individual
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Provider Name | JAMI MARIE LYONS DNP, APNP
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Gender | Female
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 10/02/2019
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Provider Practice Location Address
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Address Line | 234 CASHMAN DR
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729-3543
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Country | US
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Telephone | 715-861-1058
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Fax |
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Provider Business Mailing Address
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Address Line | 10701 W RESEARCH DR
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City | WAUWATOSA
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State | WI
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Zip | 53226-3452
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Country | US
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Telephone | 608-386-1358
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 6205-33
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License Number State | WI
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