MEDICARE: SHENAYE LYONS ARNP

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	363LF0000X	Family Nurse Practitioner	AC002580	MD
2	363LF0000X	Family Nurse Practitioner	95006148	CA
3	363LF0000X	Family Nurse Practitioner	NP1050173	DC
4	363LF0000X	Family Nurse Practitioner	ARNP9270095	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801165105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHENAYE LYONS ARNP

Provider Business Mailing Address
First Line	:	12171 SW 268TH ST
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33032-8001
Country	:	US
Telephone Number	:	52-780-2003
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 MCDUFF AVE S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-4250
Country	:	US
Telephone Number	:	45-064-0449
Fax Number	:	904-490-8544

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

Provider Enumeration Date	:	12/15/2011
Last Update Date	:	07/02/2025

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Directions to “ SHENAYE LYONS ARNP” Practice Location

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