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Kim Lydick

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2101 Northside Dr Unit 702, Panama City, FL 32405-3687

PECOS Enrollment

Based on the most recent information from CMS, provider Kim Lydick is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1326693292
Provider Type
Individual
Full Name
Lydick, Kim
Credential
APRN

Gender
Female
Sole Proprietor
Yes
Enumeration Date
8/7/2019
Last Updated
10/3/2024

Contact Information

Practice Location

2101 Northside Dr Unit 702, Panama City, FL 32405-3687

(850) 770-3210

Unlisted Fax

Mailing Location

4205 Belfort Rd Ste 4015, Jacksonville, FL 32216-3623

(904) 450-6063

(904) 539-4091

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License APRN11003603 Florida

Kim Lydick

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Caruso, Linda S

Roberts, Doris M

Mcloughlin, Lisa Patrice

Boring, Lynnetta J

World, Shawntell

Daniels, Jacqueline Charmaine

Ruder, Martha

Suarez Valderas, Arian Alejandro

Gemsch, Linda Jolene

Wright, Alyssa Lynn