Provider Demographics
NPI:1255604542
Name:ISLOW, LULA
Entity type:Individual
Prefix:
First Name:LULA
Middle Name:
Last Name:ISLOW
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 1:5973 MANOR HOUSE WAY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1533
Mailing Address - Country:US
Mailing Address - Phone:614-424-0049
Mailing Address - Fax:
Practice Address - Street 1:5973 MANOR HOUSE WAY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1533
Practice Address - Country:US
Practice Address - Phone:614-424-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.138433-M-IV164W00000X
OH379744163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse