Williams, Lystra Eastlyn
Williams, Lystra Eastlyn is an sole proprietor health care provider with primary practice located at 7310 Ritchie Hwy Ste 405 , Glen Burnie MD 21061. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Williams, Lystra Eastlyn can be contacted via phone (410) 788-6727.Contact Information
Primary practice address
7310 Ritchie Hwy Ste 405
Glen Burnie MD 21061
Phone: (410) 788-6727
Fax: (410) 788-6727
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | R132674 | Maryland |
Profile Details
| NPI number | 1871678995 |
|---|---|
| LBN Legal business name | Williams, Lystra Eastlyn |
| Credentials | CRNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 26th, 2006 |
| Last updated | Dec 5th, 2019 - about 5 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 | 1871678995 | NPPES |
| Maryland | MEDICAID | 011706400 |
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