Individual
KEVIN E LOOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN
Contact information
Practice address
511 LAUREL AVE, JOHNSON CITY, TN 37604-6643
(423) 557-9572
Mailing address
511 LAUREL AVE, JOHNSON CITY, TN 37604-6643
(423) 557-9572
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0000212462
TN
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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