Healthcare Provider Details

I. General information

NPI: 1629972179
Provider Name (Legal Business Name): MRS. CHERESE ROCQUEMORE LOFTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7580 AUBURN RD
CONCORD TWP OH
44077-9615
US

IV. Provider business mailing address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 216-541-1964
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0043600
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: