Provider Demographics
NPI:1073926226
Name:STONE, LULA
Entity Type:Individual
Prefix:
First Name:LULA
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2432 HIGHWAY 49
Mailing Address - Street 2:
Mailing Address - City:SUNFLOWER
Mailing Address - State:MS
Mailing Address - Zip Code:38778-9603
Mailing Address - Country:US
Mailing Address - Phone:662-588-8215
Mailing Address - Fax:
Practice Address - Street 1:2432 HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:SUNFLOWER
Practice Address - State:MS
Practice Address - Zip Code:38778-9603
Practice Address - Country:US
Practice Address - Phone:662-588-8215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant