Look up the most recent NPI and PECOS records

Nicole Elaine Lally

Family Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as NICOLE LALLY.

Based on the most recent information from CMS, provider Nicole Elaine Lally is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 11 days ago.

Profile Details

Provider ID
1093398349
Provider Type
Individual
Full Name
Lally, Nicole Elaine
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
5/4/2021
Last Updated
9/25/2024

Contact Information

Practice Location

250 W 5th St, Hanford, CA 93230-5029

(779) 603-4268

Unlisted Fax

Mailing Location

250 W 5th St, Hanford, CA 93230-5029

(779) 603-4268

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License A196514 California

Nicole Elaine Lally

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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