Healthcare Provider Details

I. General information

NPI: 1811758543
Provider Name (Legal Business Name): KRISTY LOFTIS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 02/11/2024
Certification Date: 02/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 PINE MOUNTAIN RD
HUDSON NC
28638-2605
US

IV. Provider business mailing address

270 PINE MOUNTAIN RD
HUDSON NC
28638-2605
US

V. Phone/Fax

Practice location:
  • Phone: 828-757-6330
  • Fax:
Mailing address:
  • Phone: 828-757-6330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5019462
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: