Individual provider · Type 1 NPI

Angharad Supe Lyon, PA-C

Student in an Organized Health Care Education/Training Program · Pocatello, ID

NPI number 1164596128 Active

Practice location

Isu Student Health Ctr, 921 S. 8th St.
Pocatello, ID 83209-0001

Call (208) 282-2330 Map

Fax (208) 282-4036

Mailing address

69 Foothill Blvd
Pocatello, ID 83204-4063

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XPA-365 (ID)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Other student in an organized health care education/training program providers in Pocatello

See all in Pocatello →

About NPI 1164596128

Angharad Supe Lyon, PA-C's National Provider Identifier is 1164596128, issued on Nov 20, 2006. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Pocatello, ID. The record was last updated on Jul 8, 2007.