Individual
DIANE S LOUGHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
231 MAPLE AVE, RED BANK, NJ 07701-1727
(732) 842-3050
(732) 530-0730
Mailing address
PO BOX 8519, RED BANK, NJ 07701-8519
(732) 460-9840
(732) 460-9848
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NN05052100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0102288
—
NJ
01
—
P00207997
MEDICARE RAILROAD
—
Enumeration date
11/15/2005
Last updated
04/28/2011
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