person
Miss Angharad Supe Lyon, PA-C
Student in an Organized Health Care Education/Training Program in Pocatello, Idaho
NPI 1164596128

Angharad Supe Lyon is a Student in an Organized Health Care Education/Training Program based in Pocatello, ID. Angharad Supe Lyon practices in Pocatello, ID and has the professional credentials of PA-C. The NPI Number for Angharad Supe Lyon is 1164596128 and holds a License No. PA-365 (Idaho).

The current practice location address for Angharad Supe Lyon is Isu Student Health Ctr, Pocatello, ID and can be reached out via phone at 208-282-2330 and via fax at 208-282-4036.

Location: Isu Student Health Ctr, Pocatello, ID, 83204-4063
person
Provider Profile Details
NPI Number
1164596128
Provider Name
Angharad Supe Lyon
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
Isu Student Health Ctr, Pocatello, ID, 83204-4063
Phone Number
208-282-2330
Fax Number
208-282-4036
Provider Enumeration Date
11/20/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
Isu Student Health Ctr
City
State
Zip
83209-0001
Phone Number
208-282-2330
Fax Number
208-282-4036
person
Provider Business Mailing Address Details
Address
Isu Student Health Ctr
City
State
Zip
83209-0001
Phone Number
208-282-2330
Fax Number
208-282-4036
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
PA-365 (Idaho)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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