Provider Demographics
NPI:1760572887
Name:LOUGHRY, KIMQ MARIE (RN,BSN,ET,CWON)
Entity Type:Individual
Prefix:
First Name:KIMQ
Middle Name:MARIE
Last Name:LOUGHRY
Suffix:
Gender:F
Credentials:RN,BSN,ET,CWON
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7180 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1206
Mailing Address - Country:US
Mailing Address - Phone:412-688-6000
Mailing Address - Fax:412-688-6898
Practice Address - Street 1:7180 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1206
Practice Address - Country:US
Practice Address - Phone:412-688-6000
Practice Address - Fax:412-688-6898
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN205247L163WE0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy