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NPI Code Detail

MEDICARE: MRS. DEBORAH G LOMAN CPNP PHD

MEDICARE: MRS. DEBORAH G LOMAN CPNP PHD
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
1363L00000XNurse Practitioner059430MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720089246
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBORAH G LOMAN CPNP PHD
Provider Business Mailing Address
First Line : 5471 DR MARTIN LUTHER KING DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63112-4265
Country : US
Telephone Number : 314-367-5820
Fax Number : 314-367-6326
Provider Business Practice Location Address
First Line : 5471 DR MARTIN LUTHER KING DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63112-4265
Country : US
Telephone Number : 314-367-5820
Fax Number : 314-367-6326
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 10/06/2011

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