MR. KENNETH RAY LYMAN FNP-BC NPI 1841447174

NPI Information

  • NPI: 1841447174
  • Provider Name: MR. KENNETH RAY LYMAN, FNP-BC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1050 W. 10TH STREET
    SUITE 300
    ROLLA, MO
    ZIP 65401
  • Phone: (573) 364-9000

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NPI Details

MR. Kenneth Ray Lyman, FNP-BC is a family nurse practitioner in Rolla, MO. MR. Kenneth Ray Lyman, FNP-BC NPI is 1841447174. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1050 W. 10TH STREET
SUITE 300
ROLLA, MO
ZIP 65401
Phone: (573) 364-9000
Fax: (573) 426-3552

The NPI 1841447174 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 8/18/2008 and was last updated on 3/27/2012.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily3491-033WISCONSINNo
2363LF0000XNurse PractitionerFamily2010033190MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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