Basic Information
Provider Information
NPI: 1386682839
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LYKINS
FirstName: NANCY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ANP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 30 W RAMPART ST
Address2: SUITE 170
City: SHELBYVILLE
State: IN
PostalCode: 461768846
CountryCode: US
TelephoneNumber: 3173923651
FaxNumber: 3173980538
Practice Location
Address1: 30 W RAMPART ST
Address2: SUITE 170
City: SHELBYVILLE
State: IN
PostalCode: 461768846
CountryCode: US
TelephoneNumber: 3173923651
FaxNumber: 3173980538
Other Information
ProviderEnumerationDate: 06/04/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X71002160AINY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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