| Doctor Name: | SUSAN B LOOMIS |
| NPI Number: | 1144343427 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN9253014 |
| Business Practice Address: | 1061 Country Club Park Deland, FL - 327248035 |
| Business Phone Number: | 8507778862 |
| Business Fax Number: | |
| Mailing Address: | 1061 Country Club Park, DELAND |
| State: | FL |
| Postal Code: | 327248035 |
| Phone Number: | 8507778862 |
| Fax Number: | |
| NPI Enumeration Date: | 04/09/2007 |
| NPI Last Update Date: | 12/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | RN9253014 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |