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Individual
DR. MARY LOU FOLLETT
Active
Individual
DR. MARY LOU FOLLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200250018NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200250018NP
STATE LICENSE
OR
Enumeration date
10/06/2006
Last updated
03/28/2016
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