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NPI Code Detail

MEDICARE: CARTER LYON RN

MEDICARE: CARTER LYON RN
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
1163W00000XRegistered Nurse95364482CA

General Provider Information

NPI Number : 1972429264
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARTER LYON RN
Provider Business Mailing Address
First Line : 525 12TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94607-4927
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 525 12TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94607-4927
Country : US
Telephone Number : 415-827-6777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2026
Last Update Date : 06/29/2026

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Directions to “ CARTER LYON RN” Practice Location

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