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Individual

JACKIE LOOMIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
11101 W LINCOLN AVE, WEST ALLIS, WI 53227-1133
(414) 327-3000
Mailing address
3630 N HICKORY LN, OCONOMOWOC, WI 53066-4532
(262) 646-1387
(262) 646-7067

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
WI

Other

Enumeration date
11/07/2007
Last updated
11/07/2007
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