Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | ARNP9223578 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP9223578 | FL |
NPI | 1003119520 |
---|---|
Provider Name | Ms. Rachel Maye Loeffler |
First Address | Titusville, FL 32796-2100 |
Second Address | Cocoa, FL 32927-4305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2010 |
Last Update Date | 14/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00427500 | (05) | FL |
FR112Z | (02) | FL |