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General NPI Number Information
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NPI Number | 1851165369
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Entity Type | Individual
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Provider Name | COURTNEY LOMAS APRN
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Gender | Female
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Dates
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Enumeration Date | 11/14/2023
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 5666 E STATE ST
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City | ROCKFORD
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State | IL
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Zip | 61108-2425
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Country | US
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Telephone | 815-227-2586
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Fax |
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Provider Business Mailing Address
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Address Line | 8268 CLEARVIEW DR
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City | ROCKFORD
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State | IL
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Zip | 61102-9730
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Country | US
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Telephone | 815-708-4876
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.028715
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 209028715
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License Number State | IL
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