KENNETH EUGENE LYDA FNP NPI 1043215999

NPI Information

Kenneth Eugene Lyda, FNP is a family nurse practitioner in Atlanta, GA with 23 years of experience. Kenneth Eugene Lyda, FNP NPI is 1043215999. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY
Graduation Year:2001

The provider's business location address is:

275 COLLIER RD NW
STE 500
ATLANTA, GA
ZIP 30309-709
Phone: (404) 605-2800
Fax: (404) 351-5983

The NPI 1043215999 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/16/2005 and was last updated on 5/16/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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