Individual
LORI PROL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-C
Contact information
Practice address
508 HIGH ST, MOUNT HOLLY, NJ 08060-1052
(609) 261-8963
Mailing address
508 HIGH STREET, CVS/MINUTE CLINIC, MOUNT HOLLY, NJ 08060-1436
(609) 261-8963
(609) 936-1219
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
26NN10236400
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NN10236400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NN10236400
APN LICENSE NUMBER
NJ
Enumeration date
07/02/2007
Last updated
08/20/2018
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