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General NPI Number Information
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NPI Number | 1093131468
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Entity Type | Individual
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Provider Name | LOREN JASON LOUK CNP
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Gender | Male
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 3768 BOARDMAN CANFIELD RD STE 5
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City | CANFIELD
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State | OH
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Zip | 44406-8502
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Country | US
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Telephone | 330-798-0491
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Fax | 330-303-4948
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Provider Business Mailing Address
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Address Line | PO BOX 3702
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City | BOARDMAN
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State | OH
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Zip | 44513-3702
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Country | US
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Telephone | 330-798-0491
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Fax | 330-303-4948
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.15708
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License Number State | OH
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