Individual
SUSAN B LOOMIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1061 COUNTRY CLUB PARK, DELAND, FL 32724-8035
(850) 777-8862
Mailing address
1061 COUNTRY CLUB PARK, DELAND, FL 32724-8035
(850) 777-8862
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN9253014
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312180100
—
FL
Enumeration date
04/09/2007
Last updated
12/02/2009
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