MEDICARE: KRISTY LOFTIS FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	5019462	NC

General Provider Information

NPI Number	:	1811758543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTY LOFTIS FNP-BC

Provider Business Mailing Address
First Line	:	270 PINE MOUNTAIN RD
Second Line	:
City	:	HUDSON
State	:	NC
Zip	:	28638-2605
Country	:	US
Telephone Number	:	828-757-6330
Fax Number	:

Provider Business Practice Location Address
First Line	:	270 PINE MOUNTAIN RD
Second Line	:
City	:	HUDSON
State	:	NC
Zip	:	28638-2605
Country	:	US
Telephone Number	:	828-757-6330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2024
Last Update Date	:	02/11/2024

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