Lollis, Mary Alice

Lollis, Mary Alice is an individual health care provider with primary practice located at 100 Gavotte Ln , Anderson SC 29621-8205. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Lollis, Mary Alice can be contacted via phone (864) 261-7474.

Contact Information

Primary practice address
100 Gavotte Ln Anderson SC 29621-8205
Phone: (864) 261-7474
Fax: (864) 261-8580
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 17911 South Carolina

Profile Details

NPI number 1922360593
LBN Legal business name Lollis, Mary Alice
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2012
Last updated Jul 21st, 2022 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1922360593 NPPES
South Carolina MEDICAID NP2056

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