Diane H Lyddon, RN, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

A01095 Issued in AR

Practice address

2400 S 48TH St
Springdale, AR 72762-6683

Phone

(479) 750-2020

Fax

(479) 750-4843

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jeffrey L Tate MD PA

  • Adult Mental Health Clinic/Center
  • Rogers, AR
  • NPI 1275877425
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1093758682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "479-750-2020",
            "fax_number": "479-750-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "479-750-2020",
            "fax_number": "479-750-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYDDON",
        "first_name": "DIANE",
        "middle_name": "H",
        "credential": "RN, APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AR",
            "license": "R15892",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "A01095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luna Wellness, PLLC
• Elise Lunsford, LPC
• Kyra Paige Luper
• Luvi Enterprises, LLC
• Tia Ly, BCBA
• Lauren Lynch
• Marie Elizabeth Lynch
• Jantsen Hunter Lynn, DPT
• Brandi Lyon
• M. Johnson Therapy Service, Inc.

• Psychiatric/Mental Health Nurse Practitioner in Springdale, AR
• Providers in Springdale, AR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.