Individual
MRS. NIKKI M LYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASTECTOMY FITTER
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
6000005357
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01726556
—
PA
Enumeration date
09/02/2006
Last updated
07/08/2007
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