Provider Demographics
NPI:1386945129
Name:MUELLER, LOIS JB (OM)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:JB
Last Name:MUELLER
Suffix:
Gender:F
Credentials:OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13920 W CAMINO DEL SOL
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4438
Mailing Address - Country:US
Mailing Address - Phone:623-474-3343
Mailing Address - Fax:
Practice Address - Street 1:13920 W CAMINO DEL SOL
Practice Address - Street 2:SUITE 1
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4438
Practice Address - Country:US
Practice Address - Phone:623-474-3343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH1420171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator