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General NPI Number Information
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NPI Number | 1982538823
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Entity Type | Individual
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Provider Name | MISTY RENEE LYONS RN, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 2211 MAIN DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-5292
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Country | US
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Telephone | 479-485-1215
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Fax |
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Provider Business Mailing Address
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Address Line | 10020 JUBILEE DR
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City | CEDARVILLE
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State | AR
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Zip | 72932-9402
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Country | US
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Telephone | 208-691-8687
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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 | 163WX0003X
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Taxonomy Name | Inpatient Obstetric Registered Nurse
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License Number | 219031
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 219031
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License Number State | AR
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