Individual
JORDAN LOEFFELHOLZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-4788
Mailing address
6809 WINDWOOD TRL, FORT WORTH, TX 76132-3042
(314) 780-6519
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
2080N0001X
TX
363LN0000X
Neonatal Nurse Practitioner
Primary
AP1018008
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1018008
APRN LICENSE NUMBER
TX
Enumeration date
10/29/2020
Last updated
03/30/2021
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