Provider Demographics
NPI:1003168071
Name:LOEBNER, JAIME REBECCA (MSN, FPMHNP-BC, APRN)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:REBECCA
Last Name:LOEBNER
Suffix:
Gender:F
Credentials:MSN, FPMHNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-5520
Mailing Address - Country:US
Mailing Address - Phone:615-766-7576
Mailing Address - Fax:
Practice Address - Street 1:113 CHRISTIAN LN
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-1350
Practice Address - Country:US
Practice Address - Phone:985-781-7353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07096363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health