LORI MACKILLOP N.P. NPI 1073535308

NPI Information

NPI: 1073535308
Provider Name: LORI MACKILLOP, N.P.
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
22255 GREENFIELD RD STE 350
SOUTHFIELD, MI
ZIP 48075
Phone: (248) 849-2710
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Lori Mackillop, N.P. is an adult health nurse practitioner in Southfield, MI. Lori Mackillop, N.P. NPI is 1073535308. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

22255 GREENFIELD RD STE 350
SOUTHFIELD, MI
ZIP 48075-712
Phone: (248) 849-2710
Fax: (248) 849-4024

The NPI 1073535308 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/24/2006 and was last updated on 1/29/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WD0400X	Registered Nurse	Diabetes Educator	4704140266	MICHIGAN	No
2	363L00000X	Nurse Practitioner		4704140266	MICHIGAN	No
3	363LA2200X	Nurse Practitioner	Adult Health	4704140266	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	110F324280	OTHER	MICHIGAN	BCBS GROUP#

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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