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General NPI Number Information
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NPI Number | 1912238171
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Entity Type | Individual
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Provider Name | ANNETTE R LYONS CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/27/2010
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 2430 EMERALD PL SUITE 201
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City | GREENVILLE
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State | NC
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Zip | 27834-5784
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Country | US
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Telephone | 252-752-2140
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Fax | 252-752-3949
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Provider Business Mailing Address
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Address Line | 2430 EMERALD PL SUITE 201
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City | GREENVILLE
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State | NC
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Zip | 27834-5784
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Country | US
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Telephone | 252-752-2140
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Fax | 252-752-3949
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 245026
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AA103001
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 2021023898
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 84224
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License Number State | NC
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