Individual
NICOLE LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-5151
(651) 254-3123
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
(651) 254-5151
(651) 254-3123
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
62252
MN
208600000X
Surgery Physician
Primary
62252
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2014
Last updated
03/17/2018
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