Provider Demographics
NPI:1437552155
Name:LOFTIN, MARSHA (FNP-C)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:LOFTIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 RIVER OAKS DR
Mailing Address - Street 2:SUITE B-103
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9779
Mailing Address - Country:US
Mailing Address - Phone:601-366-1011
Mailing Address - Fax:601-932-6111
Practice Address - Street 1:1080 RIVER OAKS DR
Practice Address - Street 2:SUITE B-103
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9779
Practice Address - Country:US
Practice Address - Phone:601-366-1011
Practice Address - Fax:601-932-6111
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR635995363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily