Provider Demographics
NPI:1699444026
Name:LYONS, JENNA SAIGE (MSN, APRN, CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:SAIGE
Last Name:LYONS
Suffix:
Gender:F
Credentials:MSN, APRN, CPNP-PC
Other - Prefix:MISS
Other - First Name:JENNA
Other - Middle Name:SAIGE
Other - Last Name:YODER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN, CPNP-PC
Mailing Address - Street 1:419 W WACKERLY ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2739
Mailing Address - Country:US
Mailing Address - Phone:989-631-9515
Mailing Address - Fax:
Practice Address - Street 1:419 W WACKERLY ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2739
Practice Address - Country:US
Practice Address - Phone:989-631-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704364620363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics