| Mr Kenneth Ray Lyman, FNP-BC | |
|
1050 W. 10th Street, Suite 300, Rolla, MO 65401 | |
| (573) 364-9000 | |
| (573) 426-3552 |
| Full Name | Mr Kenneth Ray Lyman |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 1050 W. 10th Street, Rolla, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841447174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 3491-033 (Wisconsin) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 2010033190 (Missouri) | Primary |
| Entity Name | Public Hospital District No 1 Of Mason County |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760568752 PECOS PAC ID: 0345139275 Enrollment ID: O20040310001481 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Kenneth Ray Lyman, FNP-BC 1050 W. 10th Street, Suite 300, Rolla, MO 65401 Ph: (573) 364-9000 | Mr Kenneth Ray Lyman, FNP-BC 1050 W. 10th Street, Suite 300, Rolla, MO 65401 Ph: (573) 364-9000 |
Mr. Raymond E. Bruno, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 603 S Bishop Ave, Rolla, MO 65401 Phone: 573-426-4411 Fax: 573-426-4403 | |
Alyssa Michelle Bland, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 600 Blues Lake Pkwy, Rolla, MO 65401 Phone: 573-364-8822 | |
Priti Giri, Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 11425 Flagstone Cir, Rolla, MO 65401 Phone: 573-612-4500 | |
Mr. Steven R Ballard, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1050 W 10th St, Rolla, MO 65401 Phone: 573-364-9000 Fax: 573-426-2108 | |
Ms. Candy Sadler, AGNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1000 W 10th St, Rolla, MO 65401 Phone: 573-364-9000 Fax: 573-426-2108 | |
Tiffany Williams, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1060 W 10th St, Rolla, MO 65401 Phone: 855-406-3324 Fax: 573-458-8363 | |
Ms. Y'vonda Darlene Holmes, APRN, FNP, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1605 Martin Springs Dr, Rolla, MO 65401 Phone: 573-458-6326 |