Provider Demographics
NPI:1700847555
Name:LOSHBOUGH, BRIAN J (CFNP)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:J
Last Name:LOSHBOUGH
Suffix:
Gender:M
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3656
Mailing Address - Country:US
Mailing Address - Phone:304-691-1100
Mailing Address - Fax:304-691-1183
Practice Address - Street 1:1600 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 1500
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3656
Practice Address - Country:US
Practice Address - Phone:304-691-1100
Practice Address - Fax:304-691-1183
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV34779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0166608000Medicaid
KY78009602Medicaid
OH2356552Medicaid
WVNP03292Medicare ID - Type Unspecified
WVWV2605FMedicare PIN
WVWV2605CMedicare PIN
WV5118721Medicare PIN
WVWV2605BMedicare PIN
KY78009602Medicaid
WV0166608000Medicaid
WVWV2605DMedicare PIN
WVS81505Medicare UPIN
OH2356552Medicaid
WVWV2605B859Medicare PIN
WVWV2605B279Medicare PIN