Individual
KATHLEEN A LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
301 E SAINT JOSEPH ST, GREEN BAY, WI 54301-2241
(920) 433-3630
(920) 437-0533
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1223-033
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1223-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0216697
AMERICAN NURSES CREDENTIALING CENTER
—
Enumeration date
10/02/2006
Last updated
05/31/2022
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