Petticrew, Lyra
Petticrew, Lyra is an individual health care provider with primary practice located at 110 Lynch St. , Wrangell AK 99929-1231. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Petticrew, Lyra can be contacted via phone (907) 874-3375.Contact Information
Primary practice address
110 Lynch St.
Wrangell AK 99929-1231
Phone: (907) 874-3375
Fax: (907) 874-3339
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1124237359 |
|---|---|
| LBN Legal business name | Petticrew, Lyra |
| Credentials | Master of Education (MED) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 22nd, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124237359 | NPPES |
| Alaska | MEDICAID | CM 1085 |
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