Individual
MARY ALICE LOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 GAVOTTE LN, ANDERSON, SC 29621-8205
(864) 261-7474
(864) 261-8580
Mailing address
100 GAVOTTE LN, ANDERSON, SC 29621-8205
(864) 261-7474
(864) 261-8580
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
17911
SC
363LF0000X
Family Nurse Practitioner
Primary
17911
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP2056
—
SC
Enumeration date
06/11/2012
Last updated
04/27/2026
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