Provider Demographics
NPI:1427048859
Name:LYON, CHERYL ANN (WHNP-C)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANN
Last Name:LYON
Suffix:
Gender:F
Credentials:WHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 W 109TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1303
Mailing Address - Country:US
Mailing Address - Phone:913-312-5100
Mailing Address - Fax:
Practice Address - Street 1:607 BURKARTH RD
Practice Address - Street 2:SUITE A
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-1461
Practice Address - Country:US
Practice Address - Phone:660-747-6186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006024896363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO09841038OtherBCBS OF KC PERF PROV #
MO06215014OtherBCBS OF KC GRP #
MO523566156Medicaid