Provider Demographics
NPI:1942409735
Name:WALSH, LYRIC CATHLEEN (DNP, CNM)
Entity type:Individual
Prefix:DR
First Name:LYRIC
Middle Name:CATHLEEN
Last Name:WALSH
Suffix:
Gender:F
Credentials:DNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 S LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3456
Mailing Address - Country:US
Mailing Address - Phone:810-342-1750
Mailing Address - Fax:
Practice Address - Street 1:1314 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3456
Practice Address - Country:US
Practice Address - Phone:810-342-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704228704367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
B56025047Medicare PIN