Provider Demographics
NPI:1164301925
Name:MCCONKEY, LYDIA MARIE
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:MARIE
Last Name:MCCONKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2290 GARDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3545
Mailing Address - Country:US
Mailing Address - Phone:419-812-4241
Mailing Address - Fax:
Practice Address - Street 1:2290 GARDEN BLVD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-3545
Practice Address - Country:US
Practice Address - Phone:419-812-4241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider