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NPI 1033023080

NPI 1033023080 : MISS JAYNE LILLIAN LOFTIS : BEAVERCREEK, OH

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General NPI Number Information
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    NPI Number           |    1033023080
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    Entity Type          |    Individual 
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    Provider Name        |    MISS JAYNE LILLIAN LOFTIS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/29/2026
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    Last Update Date     |    09/29/2026
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Provider Practice Location Address
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    Address Line         |    2746 COLDSPRINGS DR 
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    City                 |    BEAVERCREEK
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    State                |    OH
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    Zip                  |    45434-6646
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    Country              |    US
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    Telephone            |    937-603-9518
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2746 COLDSPRINGS DR 
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    City                 |    BEAVERCREEK
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    State                |    OH
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    Zip                  |    45434-6646
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    Country              |    US
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    Telephone            |    937-603-9518
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    136A00000X
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    Taxonomy Name        |    Registered Dietetic Technician
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    License Number       |    
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    License Number State |    NULL
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