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NPI Code Detail

MEDICARE: MRS. DEBORAH ANN LYONS NP

MEDICARE: MRS. DEBORAH ANN LYONS NP
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
1363L00000XNurse Practitioner4704164398MI

General Provider Information

NPI Number : 1891716395
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBORAH ANN LYONS NP
Provider Business Mailing Address
First Line : 3621 S STATE ST
Second Line : 700 KMS PLACE
City : ANN ARBOR
State : MI
Zip : 48108
Country : US
Telephone Number : 734-936-2047
Fax Number :
Provider Business Practice Location Address
First Line : 1500 EAST MEDICAL CENTER DR
Second Line : LEVEL 3
City : ANN ARBOR
State : MI
Zip : 48109-5856
Country : US
Telephone Number : 888-287-1082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 02/04/2008

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