Lyda Erin Nicodemus, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP61025822 Issued in WA

Practice address

9631 N Nevada St Ste 300
Spokane, WA 99218-1193

Phone

(509) 465-3919

Fax

(509) 795-0895

NPI assigned

Jun 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1376168336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S SHERMAN ST # 201",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021311",
            "telephone_number": "509-473-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9631 N NEVADA ST STE 300",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181193",
            "telephone_number": "509-465-3919",
            "fax_number": "509-795-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICODEMUS",
        "first_name": "LYDA",
        "middle_name": "ERIN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61025822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Kay Nickerson, ADN, RN
• Zita Lindell Nickeson, M.ED
• James Nickleson, CRNA
• Johnna Nickoloff, MSW, LICSWA
• Jonathan Matthew Nickoloff, M.D,
• Alyson Nicol, LICSW
• Kylie Niedermeyer, PSYD
• Andrea D Niehoff, CMA
• Elizabeth Ann Nielsen
• John Nielsen, RPH

• Nurse Practitioner in Spokane, WA
• Providers in Spokane, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.