Individual
ANALISA MIRANDA LOEWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
100 S BOYLAN AVE, RALEIGH, NC 27603-1802
(919) 833-7526
Mailing address
100 S BOYLAN AVE, RALEIGH, NC 27603-1802
(919) 833-7526
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5013936
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000343152
BCBS PIN
IN
01
—
000000485492
ANTHEM PIN - MARY ST
IN
01
—
000000485495
ANTHEM PIN - GATEWAY BLVD
IN
05
—
200489350
—
IN
Enumeration date
06/01/2005
Last updated
08/20/2024
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