Provider Demographics
NPI:1922772516
Name:LOIACONO, HALLIE (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:HALLIE
Middle Name:
Last Name:LOIACONO
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 CHESTNUT OAK TRL
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-9002
Mailing Address - Country:US
Mailing Address - Phone:828-447-8469
Mailing Address - Fax:
Practice Address - Street 1:906 COLLEGE AVE SW STE C
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5428
Practice Address - Country:US
Practice Address - Phone:828-757-5509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5014840208000000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics