Provider Demographics
NPI:1144765397
Name:LONEY, JAMES (LPN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:LONEY
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N3525 TRIELOFF RD
Mailing Address - Street 2:LOT 27
Mailing Address - City:FORT ATKINSON
Mailing Address - State:WI
Mailing Address - Zip Code:53538-8813
Mailing Address - Country:US
Mailing Address - Phone:608-208-3244
Mailing Address - Fax:
Practice Address - Street 1:N3525 TRIELOFF RD
Practice Address - Street 2:LOT 27
Practice Address - City:FORT ATKINSON
Practice Address - State:WI
Practice Address - Zip Code:53538-8813
Practice Address - Country:US
Practice Address - Phone:608-208-3244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI25543-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse