Individual
JORDAN ELIZABETH LOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1160 SERVICE RD, KIEL, WI 53042-1281
(920) 894-3322
Mailing address
N6291 PAUL RD, BRILLION, WI 54110-9428
(920) 901-6066
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15537
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100285361
—
WI
Enumeration date
07/01/2024
Last updated
08/13/2024
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