Individual
MS. LISA B LYELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
(618) 998-5668
Mailing address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
(618) 998-5668
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209-008558
IL
Other
Enumeration date
07/05/2011
Last updated
04/06/2012
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