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NPI Code Detail

MEDICARE: MS. MICHELLE MARIE LOOMIS NP

MEDICARE: MS. MICHELLE MARIE LOOMIS NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner9426560FL

General Provider Information

NPI Number : 1154398691
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE MARIE LOOMIS NP
Provider Business Mailing Address
First Line : 1550 BARKLEY CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-4539
Country : US
Telephone Number : 239-938-2000
Fax Number : 239-278-0404
Provider Business Practice Location Address
First Line : 1550 BARKLEY CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-4539
Country : US
Telephone Number : 239-938-2000
Fax Number : 239-278-0404
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 07/21/2022

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