Provider Demographics
NPI:1518501451
Name:LOFTUS, DANIELLE M (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:M
Last Name:LOFTUS
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JAMES R THOMPSON BLVD STE 2015
Mailing Address - Street 2:
Mailing Address - City:EAST SAINT LOUIS
Mailing Address - State:IL
Mailing Address - Zip Code:62201-1118
Mailing Address - Country:US
Mailing Address - Phone:618-482-6959
Mailing Address - Fax:
Practice Address - Street 1:601 JAMES R THOMPSON BLVD STE 2015
Practice Address - Street 2:
Practice Address - City:EAST SAINT LOUIS
Practice Address - State:IL
Practice Address - Zip Code:62201-1118
Practice Address - Country:US
Practice Address - Phone:618-482-6959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019039803363L00000X
IL209019704363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner