MEDICARE: EBONY NICOLE LOFTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1215625470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EBONY NICOLE LOFTON

Provider Business Mailing Address
First Line	:	333 SOUTH AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43609-3407
Country	:	US
Telephone Number	:	419-984-2309
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 SOUTH AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43609-3407
Country	:	US
Telephone Number	:	419-984-2309
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2023
Last Update Date	:	09/03/2025

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Directions to “ EBONY NICOLE LOFTON ” Practice Location

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