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:
Health care specialties
| Specialty | Code | License # | 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 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922360593 | NPPES |
| South Carolina | MEDICAID | NP2056 |
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