Healthcare Provider Details

I. General information

NPI: 1497240725
Provider Name (Legal Business Name): AMANDA LOEFFLER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 NEWMAN DR STE B
COOKEVILLE TN
38501-4396
US

IV. Provider business mailing address

4470 KNOX LN
COOKEVILLE TN
38506-6547
US

V. Phone/Fax

Practice location:
  • Phone: 931-349-7708
  • Fax:
Mailing address:
  • Phone: 931-349-7708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number24358
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: