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NPI Code Detail

MEDICARE: REBECCA JANE LOOMIS PA

MEDICARE: REBECCA JANE LOOMIS PA
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
1363AS0400XSurgical Physician Assistant50.002576RXOH

General Provider Information

NPI Number : 1841215357
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA JANE LOOMIS PA
Provider Business Mailing Address
First Line : 4336 EAGLE AVE
Second Line :
City : STOW
State : OH
Zip : 44224-2377
Country : US
Telephone Number : 234-279-1783
Fax Number :
Provider Business Practice Location Address
First Line : 18101 LORAIN AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-5612
Country : US
Telephone Number : 216-444-2069
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 03/20/2026

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Directions to “ REBECCA JANE LOOMIS PA” Practice Location

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