Individual
SHANNON LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
33 KENDALL ST, WORCESTER, MA 01605-2726
(508) 334-6255
(508) 334-6063
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2258707
MA
363LA2200X
Adult Health Nurse Practitioner
101.0080831
VT
363LA2200X
Adult Health Nurse Practitioner
RN2258707
MA
363LW0102X
Women's Health Nurse Practitioner
101.0080831
VT
363LW0102X
Women's Health Nurse Practitioner
RN2258707
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110142193A
—
MA
Enumeration date
08/20/2010
Last updated
11/13/2020
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