Individual provider · Type 1 NPI
Tyner Leigh Ray Lollis, MSN, NNP-BC
Critical Care Neonatal Nurse Practitioner · Charleston, SC
NPI number
1063770147
Active
Practice location
171 Ashley Ave
Charleston, SC 29425-4210
Mailing address
PO Box 751461
Charlotte, NC 28275-1461
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | 5005582 (NC) |
| Critical Care Neonatal Nurse Practitioner Primary | 363LN0005X | 18835 (SC) |
Critical Care Neonatal Nurse Practitioner: Definition to come...
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About NPI 1063770147
Tyner Leigh Ray Lollis, MSN, NNP-BC's National Provider Identifier is 1063770147, issued on Apr 26, 2012. The primary taxonomy on file is Critical Care Neonatal Nurse Practitioner (363LN0005X), and the practice location is in Charleston, SC. The record was last updated on May 22, 2019.