Provider Demographics
NPI:1740560614
Name:LOFTON, CARRIE A (RN, APN, ACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:A
Last Name:LOFTON
Suffix:
Gender:F
Credentials:RN, APN, ACNP-BC
Other - Prefix:MISS
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:PLEASNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:
Practice Address - Street 1:3131 LA CANADA ST STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-2579
Practice Address - Country:US
Practice Address - Phone:702-933-9400
Practice Address - Fax:702-933-9444
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.340803163W00000X
NV815854363L00000X, 363LA2100X
IL209.008547363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1720371669OtherGROUP PRACTICE NPI
ILF400094782OtherMEDICARE PTAN LOC 15
ILF400094779OtherMEDICARE PTAN LOC 16