Healthcare Provider Details

I. General information

NPI: 1083528707
Provider Name (Legal Business Name): JORDAN LOFLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DENVER ST
KANNAPOLIS NC
28083-3609
US

IV. Provider business mailing address

100 DENVER ST
KANNAPOLIS NC
28083-3609
US

V. Phone/Fax

Practice location:
  • Phone: 704-938-1131
  • Fax: 704-938-1137
Mailing address:
  • Phone: 704-938-1131
  • Fax: 704-938-1137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1311069
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: