Individual
MARION MERICK LYLES-LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
634 HIDDEN VALLEY DR, CLARKSVILLE, TN 37040-5247
(612) 323-6045
Mailing address
634 HIDDEN VALLEY DR, CLARKSVILLE, TN 37040-5247
(612) 323-6045
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
201103
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2022141217
TN
Other
Enumeration date
02/10/2023
Last updated
02/10/2023
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