Provider Demographics
NPI:1194426833
Name:LYMAN, SAMMANTHA SUE (APRN)
Entity type:Individual
Prefix:
First Name:SAMMANTHA
Middle Name:SUE
Last Name:LYMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 SE 43RD ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66609-1692
Mailing Address - Country:US
Mailing Address - Phone:785-409-8190
Mailing Address - Fax:
Practice Address - Street 1:1100 NW SOUTH OUTER RD
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-3070
Practice Address - Country:US
Practice Address - Phone:888-256-3814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5379435012363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health