Provider Demographics
NPI:1114543519
Name:LOFTON, AMY DARLENE (RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:DARLENE
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 1:554 MAPLE LEAF DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5473
Mailing Address - Country:US
Mailing Address - Phone:936-615-1141
Mailing Address - Fax:
Practice Address - Street 1:652 OLD BEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-2867
Practice Address - Country:US
Practice Address - Phone:936-615-1141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX595592163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty