Provider Demographics
NPI:1073742045
Name:LOFTON, ADDIE BEATRICE (RN)
Entity Type:Individual
Prefix:
First Name:ADDIE
Middle Name:BEATRICE
Last Name:LOFTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3087 EASTBROOK TER SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-5472
Mailing Address - Country:US
Mailing Address - Phone:513-227-0156
Mailing Address - Fax:
Practice Address - Street 1:2015 UPPERGATE DRIVE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-778-2400
Practice Address - Fax:404-727-4069
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN190035163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse