LORETTA LILLY NPI 1497795967

NPI Information

NPI: 1497795967
Provider Name: LORETTA LILLY
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
1835 GRANT AVE
JONESBORO, AR
ZIP 72401
Phone: (870) 974-9114
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Loretta Lilly is a specialist in Jonesboro, AR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Loretta Lilly NPI is 1497795967. 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:

1835 GRANT AVE
JONESBORO, AR
ZIP 72401-155
Phone: (870) 974-9114

The enumeration date for this NPI number is 6/6/2006 and was last updated on 3/21/2024.

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	174400000X	Specialist		OTA213	ARKANSAS	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	138317721	MEDICAID	ARKANSAS

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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