Judith C Lyness, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1166033 Issued in WI

Practice address

200 W Bluff St
Boscobel, WI 53805-1601

Phone

(608) 375-2424

Fax

(608) 375-6285

NPI assigned

May 11, 2006

Last updated

Dec 7, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1548210230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PARKER ST",
            "city": "BOSCOBEL",
            "state": "WI",
            "postal_code": "538051642",
            "telephone_number": "608-375-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W BLUFF ST",
            "city": "BOSCOBEL",
            "state": "WI",
            "postal_code": "538051601",
            "telephone_number": "608-375-2424",
            "fax_number": "608-375-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNESS",
        "first_name": "JUDITH",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1166033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43877300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Boscobel, WI
• Providers in Boscobel, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.