Provider Demographics
NPI:1215146089
Name:LYONS, TINA LOUISE (RN)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:LOUISE
Last Name:LYONS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 RAIN FOREST DR
Mailing Address - Street 2:APT. B
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-5665
Mailing Address - Country:US
Mailing Address - Phone:865-670-0830
Mailing Address - Fax:
Practice Address - Street 1:140 DAMERON AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-6413
Practice Address - Country:US
Practice Address - Phone:865-215-5370
Practice Address - Fax:865-215-5390
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000075968163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health