Lydia Marie Naylor, RN

Individual provider Active NPI Registered Nurse · Lake Park, GA

NPI 1922538560 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1922538560
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN051248 (GA)
Practice address
4287 Dasher Rd
Lake Park, GA 31636-4607
Phone
(229) 300-0160
NPI assigned
Jun 15, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN051248GAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN051248 GA Yes

Addresses

Primary practice location

4287 Dasher Rd
Lake Park, GA 31636-4607

Mailing address

4287 Dasher Rd
Lake Park, GA 31636-4607
Phone (229) 300-0160

Other providers in Lake Park, GA

All providers in Lake Park, GA · Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.