Doctor Name: | MRS. DORA CONNELLY LOFLIN |
NPI Number: | 1245552595 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 400039 |
Business Practice Address: | 4705 Southport Supply Rd Se Southport, NC - 284619074 |
Business Phone Number: | 9104576044 |
Business Fax Number: | 9104575220 |
Mailing Address: | 4705 Southport Supply Road, New Hope Clinic SOUTHPORT |
State: | NC |
Postal Code: | 248613914 |
Phone Number: | 9104576044 |
Fax Number: | 9104575220 |
NPI Enumeration Date: | 02/26/2010 |
NPI Last Update Date: | 02/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 400039 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |