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General NPI Number Information
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NPI Number | 1851806103
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Entity Type | Organization
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Legal Business Name | TAMMY A WILLINGHAM LOOMIS
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1220 7TH ST
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City | WOODWARD
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State | OK
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Zip | 73801-3202
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Country | US
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Telephone | 580-290-5112
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 7TH ST
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City | WOODWARD
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State | OK
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Zip | 73801-3202
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Country | US
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Telephone | 580-290-5112
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TAMMY ANN WILLINGHAM LOOMIS
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Credential | DNP, MSN APRN-CNP
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Telephone | 580-290-5112
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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 |
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License Number State |
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