Provider Demographics
NPI:1386147551
Name:LYLES, ANDREA LEIGH (APRN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LEIGH
Last Name:LYLES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:LEIGH
Other - Last Name:TURCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:7740 POINT MEADOWS DR STE 6
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9180
Mailing Address - Country:US
Mailing Address - Phone:904-389-1010
Mailing Address - Fax:
Practice Address - Street 1:7740 POINT MEADOWS DR STE 6
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9180
Practice Address - Country:US
Practice Address - Phone:904-389-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-14
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9203805363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner