Lyda, Kenneth Eugene
Lyda, Kenneth Eugene is an individual health care provider with primary practice located at 275 Collier Rd Nw Ste 500, Atlanta GA 30309-1709. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Lyda, Kenneth Eugene can be contacted via phone (404) 605-2800.Contact Information
Primary practice address
275 Collier Rd Nw Ste 500
Atlanta GA 30309-1709
Phone: (404) 605-2800
Fax: (404) 351-5983
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 124797 | Georgia |
Profile Details
| NPI number | 1043215999 |
|---|---|
| LBN Legal business name | Lyda, Kenneth Eugene |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2005 |
| Last updated | May 16th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043215999 | NPPES |
| Georgia | MEDICAID | 000925801P |
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