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NPI Code Detail

MEDICARE: ANALISA MIRANDA LOEWEN N.P.

MEDICARE: ANALISA MIRANDA LOEWEN N.P.
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
1363LF0000XFamily Nurse Practitioner5013936NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000485492OTHERINANTHEM PIN - MARY ST
2000000485495OTHERINANTHEM PIN - GATEWAY BLVD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4000000343152OTHERINBCBS PIN

General Provider Information

NPI Number : 1407858616
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANALISA MIRANDA LOEWEN N.P.
Provider Business Mailing Address
First Line : 100 S BOYLAN AVE
Second Line :
City : RALEIGH
State : NC
Zip : 27603-1802
Country : US
Telephone Number : 919-833-7526
Fax Number :
Provider Business Practice Location Address
First Line : 100 S BOYLAN AVE
Second Line :
City : RALEIGH
State : NC
Zip : 27603-1802
Country : US
Telephone Number : 919-833-7526
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 08/20/2024

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