MEDICARE: NANCY LYKINS ANP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	71002160A	IN

General Provider Information

NPI Number	:	1386682839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY LYKINS ANP

Provider Business Mailing Address
First Line	:	30 W RAMPART ST
Second Line	:	SUITE 170
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-8846
Country	:	US
Telephone Number	:	317-392-3651
Fax Number	:	317-398-0538

Provider Business Practice Location Address
First Line	:	30 W RAMPART ST
Second Line	:	SUITE 170
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-8846
Country	:	US
Telephone Number	:	317-392-3651
Fax Number	:	317-398-0538

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	07/08/2007

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