Mackillop, Lori

Mackillop, Lori is an individual health care provider with primary practice located at 22255 Greenfield Rd Ste 350 , Southfield MI 48075-3712. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Nursing Service Providers / Diabetes Educator, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Mackillop, Lori can be contacted via phone (248) 849-2710.

Contact Information

Primary practice address
22255 Greenfield Rd Ste 350 Southfield MI 48075-3712
Phone: (248) 849-2710
Fax: (248) 849-4024
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704140266 Michigan
Nursing Service Providers / Diabetes Educator 163WD0400X 4704140266 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 4704140266 Michigan

Profile Details

NPI number 1073535308
LBN Legal business name Mackillop, Lori
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Jan 29th, 2019 - about 5 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 1073535308 NPPES
Michigan Other 110F324280 BCBS GROUP#

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