Provider Demographics
NPI:1366743825
Name:LYONS, YVONNE ROSE (PRACTICAL NURSE)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:ROSE
Last Name:LYONS
Suffix:
Gender:F
Credentials:PRACTICAL NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 BAY ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-4825
Mailing Address - Country:US
Mailing Address - Phone:585-654-9339
Mailing Address - Fax:585-654-9339
Practice Address - Street 1:1121 BAY ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-4825
Practice Address - Country:US
Practice Address - Phone:585-654-9339
Practice Address - Fax:585-654-9339
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232891-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse