Individual
DR. MARY LOU FOLLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3156 STATE ST, MEDFORD, OR 97504-8450
(541) 773-9772
(541) 773-1113
Mailing address
2921 DOCTORS PARK DR, MEDFORD, OR 97504-8127
(541) 245-4444
(541) 973-2835
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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