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Individual

MR. KENNETH RAY LYMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
1050 W. 10TH STREET, SUITE 300, ROLLA, MO 65401
(573) 364-9000
(573) 426-3552
Mailing address
1050 W. 10TH STREET, SUITE 300, ROLLA, MO 65401
(573) 364-9000
(573) 426-3552

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2010033190
MO
363LF0000X
Family Nurse Practitioner
3491-033
WI

Other

Enumeration date
08/18/2008
Last updated
03/27/2012
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