Healthcare Provider Details

I. General information

NPI: 1063291797
Provider Name (Legal Business Name): TIFFANY JOY LOEWEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2023
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 N TOPEKA ST
WICHITA KS
67214-2810
US

IV. Provider business mailing address

1150 N BROADWAY AVE
WICHITA KS
67214-2805
US

V. Phone/Fax

Practice location:
  • Phone: 316-866-2000
  • Fax:
Mailing address:
  • Phone: 316-866-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number142822
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTMP-162646
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: