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General NPI Number Information
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NPI Number | 1740054469
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Entity Type | Individual
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Provider Name | RON E LOOMIS JR. APRN FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 02/04/2024
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Provider Practice Location Address
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Address Line | 14678 N DEL WEBB BLVD
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City | SUN CITY
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State | AZ
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Zip | 85351-2137
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Country | US
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Telephone | 623-933-8289
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Fax |
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Provider Business Mailing Address
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Address Line | 5918 W VIA DEL SOL DR
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City | GLENDALE
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State | AZ
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Zip | 85310-4268
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Country | US
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Telephone | 602-616-5511
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 300237
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95027011
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License Number State | CA
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