Light, Mallory Michelle

Light, Mallory Michelle is an individual health care provider with primary practice located at 1000 Health Center Dr , Mattoon IL 61938-4644. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Light, Mallory Michelle can be contacted via phone (217) 258-2440.

Contact Information

Primary practice address
1000 Health Center Dr Mattoon IL 61938-4644
Phone: (217) 258-2440
Fax: (217) 258-2186
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209-026738 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 2023001550 Missouri

Profile Details

NPI number 1093385072
LBN Legal business name Light, Mallory Michelle
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2021
Last updated Feb 20th, 2023 - about 2 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.

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